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经皮微波消融治疗 T1a 期肾癌:119 个肿瘤的安全性、技术可行性和临床结果的中期结果。

Percutaneous Microwave Ablation of Category T1a Renal Cell Carcinoma: Intermediate Results on Safety, Technical Feasibility, and Clinical Outcomes of 119 Tumors.

机构信息

Department of Interventional Therapy, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Peking University Cancer Hospital and Institute, Beijing, China.

Department of Radiology, Division of Interventional Radiology, Massachusetts General Hospital, 55 Fruit St, GRB 298, Boston, MA 02114.

出版信息

AJR Am J Roentgenol. 2021 Jan;216(1):117-124. doi: 10.2214/AJR.20.22818. Epub 2020 Nov 19.

Abstract

The purpose of this study was to assess the safety, technical results, and clinical outcomes of CT-guided percutaneous microwave ablation of category T1a renal cell carcinoma. This retrospective study investigated consecutive patients who underwent CT-guided microwave ablation for T1a renal cell carcinoma from October 2015 to May 2019. Patient demographics including tumor characteristics, comorbidities, technical details, and clinical outcomes were evaluated. Local progression-free survival and overall survival rates were estimated using the Kaplan-Meier method. One hundred-six patients including 70 men (mean age, 68.5 ± 8.9 [SD] years; range, 49-86 years) and 36 women (mean age, 69.5 ± 10.0 years; range, 50-88 years) with an overall mean age of 68.8 ± 9.2 years (range, 49-88 years) with 119 T1a renal cell carcinomas were treated with CT-guided microwave ablation. Technical success was achieved for 100% of the tumors. Complete response was achieved in 101 (95.3%) patients and partial response was achieved in five (4.7%) patients. Local progression-free survival was 100.0%, 92.8%, and 90.6% at 1, 2, and 3 years, respectively. Overall survival was 99.0%, 97.7%, and 94.6% at 1, 2, and 3 years, respectively. Six patients (5.7%) had seven complications (five with Clavien-Dindo Grade I, Society of Interventional Radiology [SIR] category A, two with Clavien-Dindo Grade III, SIR category B) within 30 days of the procedure. CT-guided percutaneous microwave ablation is associated with high rates of technical success, excellent local progression-free survival and overall survival, and a low complication rate for category T1a renal cell carcinoma.

摘要

本研究旨在评估 CT 引导下经皮微波消融治疗 T1a 期肾癌的安全性、技术结果和临床疗效。本回顾性研究纳入了 2015 年 10 月至 2019 年 5 月期间接受 CT 引导下微波消融治疗 T1a 期肾癌的连续患者。评估了患者的人口统计学特征,包括肿瘤特征、合并症、技术细节和临床结果。采用 Kaplan-Meier 法估计局部无进展生存率和总生存率。

本研究共纳入 106 例患者,其中 70 例为男性(平均年龄 68.5±8.9[标准差]岁;年龄范围为 49-86 岁),36 例为女性(平均年龄 69.5±10.0 岁;年龄范围为 50-88 岁),总体平均年龄为 68.8±9.2 岁(年龄范围为 49-88 岁),共治疗 119 个 T1a 期肾癌。100%的肿瘤技术成功。101 例(95.3%)患者达到完全缓解,5 例(4.7%)患者达到部分缓解。1、2、3 年的局部无进展生存率分别为 100.0%、92.8%和 90.6%。1、2、3 年的总生存率分别为 99.0%、97.7%和 94.6%。术后 30 天内,6 例(5.7%)患者发生 7 例并发症(5 例为 Clavien-Dindo 分级 I 级,SIR 分级 A,2 例为 Clavien-Dindo 分级 III 级,SIR 分级 B)。

CT 引导下经皮微波消融治疗 T1a 期肾癌技术成功率高,局部无进展生存率和总生存率高,并发症发生率低。

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