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Birt-Hogg-Dubé 综合征患者肾细胞癌的经皮热消融治疗。

Percutaneous thermal ablation for renal cell carcinoma in patients with Birt-Hogg-Dubé syndrome.

机构信息

Department of Radiology, Okayama University Medical School, 2-5-1 Shikata-cho, Kita-ku, Okayama 700-8558, Japan.

Department of Radiology, Okayama University Medical School, 2-5-1 Shikata-cho, Kita-ku, Okayama 700-8558, Japan.

出版信息

Diagn Interv Imaging. 2019 Nov;100(11):671-677. doi: 10.1016/j.diii.2019.06.009. Epub 2019 Jul 10.

Abstract

PURPOSE

The purpose of this study was to analyze the outcome of patients with Birt-Hogg-Dubé (BHD) syndrome who underwent percutaneous thermal ablation of renal cell carcinoma (RCC).

MATERIALS AND METHODS

Six patients with genetically proven BHD syndrome who underwent one or more sessions of percutaneous thermal ablation for the treatment of RCC were included. There were 4 men and 2 women, with a mean age of 57.3±7.5 [SD] years (range: 44-67years). A total of 29 RCCs (1-16 tumors per patient) were treated during 20 thermal ablation sessions (7 with radiofrequency ablation and 13 with cryoablation). Outcomes of thermal ablation therapy were assessed, including technical success, adverse events, local tumor progression, development of metastases, survival after thermal ablation, and changes in renal function.

RESULTS

Technical success was achieved in all ablation sessions (success rate, 100%). No grade 4 or 5 adverse events were observed. All patients were alive with no distant metastasis during a median follow-up period of 54months (range: 6-173months). No local tumor progression was found. The mean decrease in estimated glomerular filtration rate during follow-up was 10.7mL/min/1.73m. No patients required dialysis or renal transplantation.

CONCLUSION

Radiofrequency ablation and cryoablation show promising results for the treatment of RCCs associated with BHD syndrome. Percutaneous thermal ablation may be a useful treatment option for this rare hereditary condition.

摘要

目的

本研究旨在分析经皮热消融治疗 Birt-Hogg-Dubé(BHD)综合征患者肾细胞癌(RCC)的结果。

材料和方法

纳入 6 例经基因证实的 BHD 综合征患者,这些患者因 RCC 接受了一次或多次经皮热消融治疗。其中男性 4 例,女性 2 例,平均年龄 57.3±7.5[SD]岁(范围:44-67 岁)。在 20 次热消融治疗中(射频消融 7 次,冷冻消融 13 次)共治疗了 29 个 RCC(每个患者 1-16 个肿瘤)。评估了热消融治疗的结果,包括技术成功率、不良事件、局部肿瘤进展、转移发展、热消融后的生存情况以及肾功能变化。

结果

所有消融治疗均达到技术成功(成功率 100%)。未观察到 4 级或 5 级不良事件。在中位随访 54 个月(范围:6-173 个月)期间,所有患者均存活且无远处转移。未发现局部肿瘤进展。随访期间估算肾小球滤过率平均下降 10.7mL/min/1.73m。无患者需要透析或肾移植。

结论

射频消融和冷冻消融治疗 BHD 综合征相关 RCC 具有良好的前景。经皮热消融可能是这种罕见遗传性疾病的一种有用的治疗选择。

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