University of Wisconsin School of Medicine and Public Health, 600 Highland Avenue, E3/376 Clinical Science Center, Madison, WI, 53792, USA.
Department of Urology, University of Wisconsin School of Medicine and Public Health, 600 Highland Avenue, E3/376 Clinical Science Center, Madison, WI, 53792, USA.
Abdom Radiol (NY). 2018 Sep;43(9):2446-2454. doi: 10.1007/s00261-018-1498-z.
The purpose of the article is to evaluate the safety and oncologic efficacy of microwave ablation for metastatic renal cell carcinoma (mRCC).
From September 2011 to December 2016, 33 mRCC were ablated in 18 patients using percutaneous microwave ablation. Sites of mRCC include retroperitoneum (n = 12), contralateral kidney (n = 6), liver (n = 6), lung (n = 5), adrenal gland (n = 5). Technical success, local, and distant tumor progression, and complications were assessed at immediate and follow-up imaging. The Kaplan-Meier method was used for survival analysis.
Technical success was achieved for 33/33 (100%) mRCC tumors. Ablation provided durable local control for 28/30 (93%) mRCC tumors in 17 patients at a median duration of clinical and imaging follow-up of 1.6 years (IQR 0.7-3.6) and 0.8 years (IQR 0.5-2.7), respectively. In-hospital and perioperative mortality was 0%. There were 5 (15%) procedure-related complications including one high-grade event (Clavien-Dindo III). Four patients have died from mRCC at a median of 1.3 years (range 0.7-5.1) following ablation. Estimated OS (95% CI number still at risk) at 1, 2, and 5 years were 86% (53-96%, 11), 75% (39-92%, 8), and 75% (39-92%, 3), respectively.
Microwave ablation of oligometastatic renal cell carcinoma is safe and provides durable local control in appropriately selected patients.
本文旨在评估微波消融治疗转移性肾细胞癌（mRCC）的安全性和肿瘤学疗效。
2011 年 9 月至 2016 年 12 月，18 例患者共 33 个 mRCC 病灶接受经皮微波消融治疗。mRCC 病灶部位包括腹膜后（n=12）、对侧肾脏（n=6）、肝脏（n=6）、肺（n=5）、肾上腺（n=5）。在即刻和随访影像学检查中评估技术成功率、局部和远处肿瘤进展以及并发症。采用 Kaplan-Meier 法进行生存分析。
33/33（100%）mRCC 肿瘤均达到技术成功。17 例患者中，28/30（93%）mRCC 肿瘤在中位 1.6 年（IQR 0.7-3.6）和 0.8 年（IQR 0.5-2.7）的临床和影像学随访中获得持久的局部控制。住院期间和围手术期死亡率为 0%。有 5 例（15%）发生与手术相关的并发症，包括 1 例 3 级事件（Clavien-Dindo III 级）。4 例患者在消融后中位 1.3 年（范围 0.7-5.1 年）死于 mRCC。1、2 和 5 年的估计 OS（95%CI 尚存风险人数）分别为 86%（53-96%，11 例）、75%（39-92%，8 例）和 75%（39-92%，3 例）。
微波消融治疗寡转移肾细胞癌是安全的，可在适当选择的患者中提供持久的局部控制。
