Maria Tsitskari, Georgiades Christos
Vascular & Interventional Radiology, American Medical Center, Nicosia, Cyprus; Johns Hopkins University, Baltimore, USA.
J Kidney Cancer VHL. 2015 Jun 9;2(3):105-113. doi: 10.15586/jkcvhl.2015.34. eCollection 2015.
Renal cell carcinoma (RCC) is the most common type of kidney cancer in adults. Nephron sparing resection (partial nephrectomy) has been the "gold standard" for the treatment of resectable disease. With the widespread use of cross sectional imaging techniques, more cases of renal cell cancers are detected at an early stage, i.e. stage 1A or 1B. This has provided an impetus for expanding the nephron sparing options and especially, percutaneous ablative techniques. Percutaneous ablation for RCC is now performed as a standard therapeutic nephron-sparing option in patients who are poor candidates for resection or when there is a need to preserve renal function due to comorbid conditions, multiple renal cell carcinomas, and/or heritable renal cancer syndromes. During the last few years, percutaneous cryoablation has been gaining acceptance as a curative treatment option for small renal cancers. Clinical studies to date indicate that cryoablation is a safe and effective therapeutic method with acceptable short and long term outcomes and with a low risk, in the appropriate setting. In addition it seems to offer some advantages over radio frequency ablation (RFA) and other thermal ablation techniques for renal masses.
肾细胞癌(RCC)是成人中最常见的肾癌类型。保留肾单位切除术(部分肾切除术)一直是可切除疾病治疗的“金标准”。随着横断面成像技术的广泛应用,更多的肾细胞癌病例在早期即1A期或1B期被检测出来。这为扩大保留肾单位的选择,尤其是经皮消融技术提供了动力。对于那些不适合手术切除或因合并症、多发肾细胞癌和/或遗传性肾癌综合征而需要保留肾功能的患者,经皮消融治疗肾细胞癌现已成为一种标准的保留肾单位治疗选择。在过去几年中,经皮冷冻消融已逐渐被接受为小肾癌的一种根治性治疗选择。迄今为止的临床研究表明,在适当的情况下,冷冻消融是一种安全有效的治疗方法,具有可接受的短期和长期疗效,且风险较低。此外,与射频消融(RFA)和其他热消融技术相比,它似乎对肾肿块具有一些优势。