Department of Interventional Radiology, Nouvel Hôpital Civil, 1, place de l'hôpital, 67096, Strasbourg Cedex, France.
Department of Radiology, St. Antonius Hospital, Niewegein, the Netherlands.
Eur Radiol. 2019 Nov;29(11):6293-6299. doi: 10.1007/s00330-019-06191-y. Epub 2019 Apr 15.
To investigate the safety profile of percutaneous cryoablation of renal tumours < 7 cm, utilising data extracted from an international multicentre registry.
A retrospective review of all immediate and delayed complications from a multicentre database was performed and was categorised according to the Clavien-Dindo classification. Statistical analysis was performed for both overall complications (all Clavien-Dindo) and major complications (Clavien-Dindo 3 to 5). The following criteria were identified as potential predictive factors for complications: centre number, modality of image guidance, tumour size (≤ 4 cm vs. > 4 cm), number of tumours treated in the same session (1 vs. > 1) and tumour histology.
A total of 713 renal tumours underwent ablation in 647 individual sessions. In 596 of the cases, one tumour was treated; in the remaining 51 cases, several tumours were treated per session. Mean lesion size was 2.8 cm. Fifty-four complications (Clavien-Dindo 1 to 5) occurred as a result of the 647 procedures, corresponding to an overall complication rate of 8.3%. The most frequent complication was bleeding (3.2%), with 9 cases (1.4%) requiring subsequent treatment. The rate of major complication was 3.4%. The only statistically significant prognostic factor for a major complication was a tumour size > 4 cm.
Percutaneous renal cryoablation is associated with a low rate of complications. Tumours measuring more than 4 cm are associated with a higher risk of major complications.
• Percutaneous kidney cryoablation has a low rate of complications. • Bleeding is the most frequent complication. • A tumour size superior to 4 cm is a predictive factor of major complication.
利用国际多中心登记处提取的数据，研究<7cm 肾肿瘤经皮冷冻消融的安全性。
对多中心数据库中所有即时和迟发性并发症进行回顾性分析，并根据 Clavien-Dindo 分类进行分类。对所有并发症（所有 Clavien-Dindo）和主要并发症（Clavien-Dindo 3-5）进行统计学分析。确定以下标准作为并发症的潜在预测因素：中心数量、图像引导方式、肿瘤大小（≤4cm 与>4cm）、同一治疗期内治疗的肿瘤数量（1 个与>1 个）和肿瘤组织学。
共有 713 个肾肿瘤在 647 个单独的治疗中接受消融。在 596 例病例中，每个肿瘤单独治疗；在其余 51 例病例中，每个治疗期内多个肿瘤同时治疗。平均病变大小为 2.8cm。647 次操作中有 54 次（Clavien-Dindo 1-5）发生并发症，总并发症发生率为 8.3%。最常见的并发症是出血（3.2%），有 9 例（1.4%）需要进一步治疗。主要并发症发生率为 3.4%。唯一具有统计学意义的主要并发症预测因素是肿瘤大小>4cm。
经皮肾冷冻消融术并发症发生率低。肿瘤大小>4cm 与主要并发症风险增加相关。
• 经皮肾冷冻消融术并发症发生率低。• 出血是最常见的并发症。• 肿瘤大小超过 4cm 是发生主要并发症的预测因素。
