Department of Oncology and Hematology-Oncology, Università Degli Studi di Milano, Milan, Italy.
Division of Interventional Radiology, IEO, European Institute of Oncology IRCCS, Milan, Italy.
Int J Hyperthermia. 2020;37(1):660-667. doi: 10.1080/02656736.2020.1778801.
To evaluate feasibility, safety and efficacy of image-guided thermal ablations associated with retrograde pyeloperfusion in patients with centrally located renal tumors. 48 patients (15 women, 33 men, mean age 69.1 ± 11.8) were treated with image-guided thermal ablation associated with pyeloperfusion for 58 centrally located renal tumors (mean diameter 32.3 ± 7.32 mm). 7 patients had a single kidney. Microwave and radiofrequency ablation were used. All treatments were performed with ultrasound, CT, or fusion imaging guidance under general anesthesia and simultaneous retrograde cold pyeloperfusion technique. Procedure was feasible in all cases. Technical success and primary technical efficacy were reached in 51/58 (88%) and 45/54 tumors (83%). With a second ablation performed in 5 tumors, secondary technical efficacy was achieved in 50/50 (100%) tumors. Minor and major complications occurred in 8/58 (13%) and 5/58 (8%) tumors. No significative change in renal function occurred after treatment.During follow-up, 5 recurrences occurred, that were retreated with a second ablation. At last follow up (mean 32.2 ± 22.0 months), 41/48 (85%) treated patients were free from disease. The median TTP and PFS were 27.0 (range, 2.3-80.0) and 26.5 months (range, 2.3-80.0), respectively. Image-guided thermal ablation associated with protective pyeloperfusion is a feasible, safe, and effective treatment option for patients with central renal tumors with a minimal impact on renal function and relevant potential to avoid nephrectomy.
评估影像引导下热消融联合顺行肾盂灌注治疗中央型肾肿瘤的可行性、安全性和疗效。48 例患者（15 例女性，33 例男性，平均年龄 69.1±11.8 岁）接受了影像引导下热消融联合肾盂灌注治疗 58 个中央型肾肿瘤（平均直径 32.3±7.32mm）。7 例患者为单肾。采用微波和射频消融。所有治疗均在全身麻醉下，同时采用逆行冷肾盂灌注技术，在超声、CT 或融合影像引导下进行。所有病例均可行该操作。58 例中的 51 例（88%）和 54 例中的 45 例（83%）达到了技术成功和主要技术疗效。在另外 5 例肿瘤中进行了二次消融，50 例（100%）达到了二次技术疗效。58 例肿瘤中有 8 例（13%）和 5 例（8%）出现了轻微和严重并发症。治疗后肾功能无明显变化。随访期间，5 例肿瘤复发，均行二次消融治疗。末次随访（平均 32.2±22.0 个月）时，48 例治疗患者中有 41 例（85%）无疾病。中位 TTP 和 PFS 分别为 27.0（范围 2.3-80.0）和 26.5 个月（范围 2.3-80.0）。影像引导下热消融联合保护性肾盂灌注治疗中央型肾肿瘤是一种可行、安全、有效的治疗方法，对肾功能影响最小，并有避免肾切除的潜力。
