Chan P, Vélasco S, Vesselle G, Boucebci S, Herpe G, Debaene B, Ingrand P, Irani J, Tasu J-P
Imaging Department, CHU de Poitiers, 2 rue de la milétrie, 86000 CHU de Poitiers, France.
Anesthesiology Department, CHU de Poitiers, 2 rue de la milétrie, 86000 CHU de Poitiers, France.
Clin Radiol. 2017 Sep;72(9):786-792. doi: 10.1016/j.crad.2017.03.029. Epub 2017 May 22.
To evaluate the safety and efficiency of percutaneous microwave ablation (MWA) of renal cell carcinomas (RCC) carried out under computed tomography (CT) guidance.
A retrospective study was performed on RCC that was either histologically proven or diagnosed at imaging (Bosniak IV cyst) and treated by MWA under general anaesthesia with CT guidance. Indications for percutaneous ablation were based on the American Urological Association recommendations. Twenty-four months post-procedure follow-up was performed.
Sixty-two patients presenting one or more RCC (84 tumours ranging from 10-48 mm in diameter; mean diameter: 25.6 mm) were included. Technical success was achieved for 78 tumours (58 patients). For four patients, the treatment was stopped due to gas dissection failure. At 3 months, six residual tumours were observed (8%). At 6 months, two recurrences and one residual tumour (3.8%) were observed; all were retreated with complete success. At 12 months, local control of the disease was achieved in 94% of cases (100% in cases where treatment was performed). Two cases of distal metastasis were observed after 12 and 24 months. At 24 months, one patient presented with a contralateral tumour. The complication rate was 4.8% including one grade III complication and two grade II complications according to the Clavien-Dindo classification. At 2 years, the cumulative disease-free survival rate and overall survival were 95% and 97%, respectively.
MWA ablation under CT guidance to treat RCC is safe and provides a high rate of effectiveness at 24 months.
评估在计算机断层扫描（CT）引导下进行肾细胞癌（RCC）经皮微波消融（MWA）的安全性和有效性。
对经组织学证实或影像学诊断（博斯尼亚克IV级囊肿）且在CT引导下全身麻醉下行MWA治疗的RCC患者进行回顾性研究。经皮消融的适应证基于美国泌尿外科学会的建议。术后进行24个月的随访。
纳入62例患有一个或多个RCC的患者（84个肿瘤，直径10 - 48毫米；平均直径：25.6毫米）。78个肿瘤（58例患者）技术成功。4例患者因气体分离失败而停止治疗。3个月时，观察到6个残留肿瘤（8%）。6个月时，观察到2例复发和1个残留肿瘤（3.8%）；所有均再次治疗并完全成功。12个月时，94%的病例实现了疾病的局部控制（治疗的病例中为100%）。12个月和24个月后观察到2例远处转移。24个月时，1例患者出现对侧肿瘤。根据Clavien-Dindo分类，并发症发生率为4.8%，包括1例III级并发症和2例II级并发症。2年时，累积无病生存率和总生存率分别为95%和97%。
CT引导下MWA消融治疗RCC是安全的，且在24个月时具有较高的有效性。
