Curry David, Pahuja Ajay, Loan Willie, Thwaini Ali
Department of Urology, Belfast City Hospital, Belfast, UK.
Department of Radiology, Belfast City Hospital, Belfast, UK.
Curr Urol. 2018 Jun;11(4):196-200. doi: 10.1159/000447218. Epub 2018 Mar 30.
To describe oncological outcomes, effects on renal function and complications with radiofrequency ablation (RFA) of T1 renal tumors in an 8-year experience.
A retrospective study of RFA in 89 consecutive patients between 2005 and 2013 was undertaken. Those with metastatic disease, incomplete follow-up, genetic pre-disposition to renal tumors and biopsy proven benign pathology were excluded, with 79 patients meeting inclusion criteria. Data was collected on demographics, oncological outcomes, complications and effects on renal function.
We demonstrate 94% disease-free survival at median follow-up of 29 months in a population consisting of 42 T1a and 37 T1b tumors. No disease related deaths were recorded in the follow-up period. Post-RFA decline in renal function was shown to correlate with tumor size and increased age (p = 0.0009/0.0021). Pre-existing renal impairment was a risk for post-RFA function decline (p < 0.005). Two complications were encountered in the series.
RFA produces durable oncological outcomes in T1 tumors with a minimal effect on renal function and low risk of complications. Patients at risk of developing renal impairment can be identified from described risk factors.
通过8年的经验描述T1期肾肿瘤射频消融(RFA)的肿瘤学结局、对肾功能的影响及并发症。
对2005年至2013年间连续89例患者进行RFA的回顾性研究。排除有转移性疾病、随访不完整、有肾肿瘤遗传易感性及活检证实为良性病理的患者,79例患者符合纳入标准。收集患者人口统计学、肿瘤学结局、并发症及对肾功能影响的数据。
在由42例T1a和37例T1b肿瘤组成的人群中,中位随访29个月时无病生存率为94%。随访期间未记录到与疾病相关的死亡。RFA后肾功能下降与肿瘤大小和年龄增加相关(p = 0.0009/0.0021)。术前存在肾功能损害是RFA后功能下降的一个风险因素(p < 0.005)。该系列中出现了2例并发症。
RFA对T1期肿瘤产生持久的肿瘤学结局,对肾功能影响极小,并发症风险低。可根据所述风险因素识别有发生肾功能损害风险的患者。