100 例经病理证实的肾细胞癌患者行经皮射频消融治疗后的长期生存。
Long-Term Survival after Percutaneous Radiofrequency Ablation of Pathologically Proven Renal Cell Carcinoma in 100 Patients.
机构信息
Department of Abdominal Radiology, David Geffen School of Medicine at the University of California, Los Angeles, BL-428 CHS, Room B2-187, 10833 Le Conte Ave., Los Angeles, CA 90095; Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada.
Department of Abdominal Radiology, David Geffen School of Medicine at the University of California, Los Angeles, BL-428 CHS, Room B2-187, 10833 Le Conte Ave., Los Angeles, CA 90095.
出版信息
J Vasc Interv Radiol. 2020 Jan;31(1):15-24. doi: 10.1016/j.jvir.2019.09.011. Epub 2019 Nov 22.
PURPOSE
To determine the long-term survival of patients treated with percutaneous radiofrequency (RF) ablation for pathologically proven renal cell carcinoma (RCC).
MATERIALS AND METHODS
In this single-center retrospective study, 100 patients with 125 RCCs (100 clear-cell, 19 papillary, and 6 chromophobe) 0.8-8 cm in size treated with RF ablation were evaluated at a single large tertiary-care center between 2004 and 2015. Technical success, primary and secondary technique efficacy, and pre- and postprocedural estimated glomerular filtration rate (eGFR) at 3-6 months and 2-3 years were recorded. Overall survival, cancer-specific survival, and local tumor progression-free survival were calculated by Kaplan-Meier survival curves. Complications were classified per the Clavien-Dindo system. Statistical testing was done via χ tests for proportions and paired t test for changes in eGFR. Statistical significance was set at α = 0.05.
RESULTS
Overall technical success rate was 100%, and primary and secondary technique efficacy rates were 90% and 100%, respectively. Median follow-up was 62.8 months, ranging from 1 to 120 months. The 10-year overall, cancer-specific, and local progression-free survival rates were 32%, 86%, and 92%, respectively. The number of ablation probes used was predictive of residual unablated tumor (P < .001). There were no significant changes in preprocedure vs 2-3-years postprocedure eGFR (65.2 vs 62.1 mL/min/1.73 m; P = .443). There was a 9% overall incidence of complications, the majority of which were grade I.
CONCLUSIONS
Image-guided percutaneous RF ablation of RCCs is effective at achieving local control and preventing cancer-specific death within 10 years from initial treatment.
目的
确定经皮射频（RF）消融治疗病理证实的肾细胞癌（RCC）患者的长期生存情况。
材料和方法
在这项单中心回顾性研究中，我们在 2004 年至 2015 年间，在一家大型三级保健中心评估了 100 例 125 个 RCC（100 个透明细胞癌、19 个乳头状癌和 6 个嫌色细胞癌）患者的情况，这些患者的肿瘤大小为 0.8-8cm，接受了 RF 消融治疗。记录技术成功率、原发和继发技术疗效以及术前和术后 3-6 个月和 2-3 年内估算肾小球滤过率（eGFR）。通过 Kaplan-Meier 生存曲线计算总生存率、癌症特异性生存率和局部肿瘤无进展生存率。并发症按 Clavien-Dindo 系统分类。通过 χ 检验进行比例检验，通过配对 t 检验进行 eGFR 变化的统计检验。统计学意义设为 α = 0.05。
结果
总体技术成功率为 100%，原发和继发技术疗效率分别为 90%和 100%。中位随访时间为 62.8 个月，范围为 1 至 120 个月。10 年总生存率、癌症特异性生存率和局部无进展生存率分别为 32%、86%和 92%。消融探针的使用数量与残留未消融肿瘤有关（P<0.001）。术前与术后 2-3 年 eGFR 无显著变化（65.2 与 62.1 mL/min/1.73 m；P=0.443）。总的并发症发生率为 9%，大多数为 1 级。
结论
经皮影像引导 RF 消融治疗 RCC 可有效实现局部控制，并在初始治疗后 10 年内预防癌症特异性死亡。
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