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单家退伍军人事务部医疗中心对肾细胞癌进行射频和微波消融后的长期临床结果

Long-Term Clinical Outcomes Following Radiofrequency and Microwave Ablation of Renal Cell Carcinoma at a Single VA Medical Center.

作者信息

Abboud Salim E, Patel Tanay, Soriano Stephanie, Giesler Joseph, Alvarado Nannette, Kang Preet

机构信息

Department of Radiology, University Hospitals Cleveland Medical Center and Seidman Cancer Center, Cleveland, OH.

Case Western Reserve University School of Medicine, Cleveland, OH.

出版信息

Curr Probl Diagn Radiol. 2018 Mar-Apr;47(2):98-102. doi: 10.1067/j.cpradiol.2017.05.006. Epub 2017 May 17.

Abstract

PURPOSE

Microwave ablation (MWA) is a relatively newer treatment modality for treatment of renal cell carcinoma (RCC), and only a few small studies have examined the short- and long-term outcomes for MWA applied to renal tumors. The purpose of this retrospective review is to assess the initial experience including technical short- and long-term success rates of using radiofrequency ablation (RFA) and MWA for RCC at a single Veterans Affairs (VA) medical center.

MATERIALS AND METHODS

Tumor characteristics were recorded using the R.E.N.A.L. nephrometry score. Group comparisons were performed by using univariate logistic regression analysis to determine factors affecting primary treatment success, failure, and effectiveness. Kaplan-Meier local tumor progression-free survival following ablation was calculated.

RESULTS

MWA and RFA groups were not significantly different in primary treatment success (P = 0.82). MWA primary treatment success (90.2%) was not associated with R.E.N.A.L criteria, whereas primary success in the RFA group (88.2%) was predicted by smaller tumor size (P = 0.002). Primary treatment effectiveness rates were not significantly different in MWA (88.2%) and RFA (80.3%) groups (P = 0.29). Although overall primary technique effectiveness was associated with size (P = 0.02), univariate analysis showed a significant association between tumor size and primary effectiveness for RFA (P = 0.002) but not MWA. There was no significant association between R.E.N.A.L score or criteria and primary treatment effectiveness in the RFA or MWA groups.

CONCLUSION

RFA and MWA both represent effective treatment modalities for RCC; larger tumor size may be associated with decreased efficacy of thermal ablation techniques.

摘要

目的

微波消融(MWA)是一种相对较新的治疗肾细胞癌(RCC)的方法,仅有少数小型研究探讨了将MWA应用于肾肿瘤的短期和长期疗效。本回顾性研究的目的是评估在一家退伍军人事务(VA)医疗中心使用射频消融(RFA)和MWA治疗RCC的初步经验,包括技术上的短期和长期成功率。

材料与方法

使用R.E.N.A.L.肾计量评分记录肿瘤特征。通过单因素逻辑回归分析进行组间比较,以确定影响初始治疗成功、失败和疗效的因素。计算消融后Kaplan-Meier局部肿瘤无进展生存率。

结果

MWA组和RFA组在初始治疗成功率方面无显著差异(P = 0.82)。MWA的初始治疗成功率(90.2%)与R.E.N.A.L.标准无关,而RFA组的初始成功率(88.2%)可通过较小的肿瘤大小预测(P = 0.002)。MWA组(88.2%)和RFA组(80.3%)的初始治疗有效率无显著差异(P = 0.29)。尽管总体初始技术疗效与肿瘤大小相关(P = 0.02),但单因素分析显示肿瘤大小与RFA的初始疗效显著相关(P = 0.002),而与MWA无关。R.E.N.A.L.评分或标准与RFA或MWA组的初始治疗疗效之间无显著关联。

结论

RFA和MWA都是治疗RCC的有效方法;较大的肿瘤大小可能与热消融技术疗效降低有关。

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