Mauri Giovanni, Mistretta Francesco Alessandro, Bonomo Guido, Camisassi Nicola, Conti Andrea, Vigna Paolo Della, Ferro Matteo, Luzzago Stefano, Maiettini Daniele, Musi Gennaro, Piacentini Nicolò, Varano Gianluca Maria, Orsi Ottavio de Cobelli And Franco
Division of Interventional Radiology, IEO, European Institute of Oncology IRCCS, Milan 20141, Italy.
Department of Oncology and Hematology-Oncology, Università degli Studi di Milano, Milan 20122, Italy.
Cancers (Basel). 2020 May 7;12(5):1183. doi: 10.3390/cancers12051183.
Image-guided thermal ablations are increasingly applied in the treatment of renal cancers, under the guidance of ultrasound (US) or computed tomography (CT). Sometimes, multiple ablations are needed. The aim of the present study was to evaluate the long-term results in patients with renal mass treated with radiofrequency ablation (RFA) with both US and CT, with a focus on the multiple ablations rate. 149 patients (median age 67 years) underwent RFA from January 2008 to June 2015. Median tumor diameter was 25 mm (IQR 17-32 mm). Median follow-up was 54 months (IQR 44-68). 27 (18.1%) patients received multiple successful ablations, due to incomplete ablation (10 patients), local tumor progression (8 patients), distant tumor progression (4 patients) or multiple tumor foci (5 patients), with a primary and secondary technical efficacy of 100%. Complications occurred in 13 (8.7%) patients (6 grade A, 5 grade C, 2 grade D). 24 patients died during follow-up, all for causes unrelated to renal cancer. In conclusion, thermal ablations with the guidance of US and CT are safe and effective in the treatment of renal tumors in the long-term period, with a low rate of patients requiring multiple treatments over the course of their disease.
在超声(US)或计算机断层扫描(CT)引导下,图像引导热消融在肾癌治疗中的应用越来越广泛。有时,需要进行多次消融。本研究的目的是评估在US和CT引导下接受射频消融(RFA)治疗的肾肿块患者的长期结果,重点关注多次消融率。2008年1月至2015年6月,149例患者(中位年龄67岁)接受了RFA治疗。肿瘤中位直径为25mm(四分位间距17 - 32mm)。中位随访时间为54个月(四分位间距44 - 68)。27例(18.1%)患者因消融不完全(10例)、局部肿瘤进展(8例)、远处肿瘤进展(4例)或多个肿瘤病灶(5例)接受了多次成功消融,一次和二次技术疗效均为100%。13例(8.7%)患者发生并发症(6例A级,5例C级,2例D级)。24例患者在随访期间死亡,均与肾癌无关。总之,在US和CT引导下的热消融在长期治疗肾肿瘤方面是安全有效的,在疾病过程中需要多次治疗的患者比例较低。