Department of Urology, University of Iowa, Iowa City, Iowa, USA.
Biostatistics Core, Holden Comprehensive Cancer Center, University of Iowa, Iowa City, Iowa, USA.
J Endourol. 2020 Nov;34(11):1134-1140. doi: 10.1089/end.2020.0348. Epub 2020 Jul 31.
To investigate the safety of microwave ablation (MWA) as an emerging technology for treating small renal masses. Patients with renal masses treated at a high-volume center with MWA between March 2015 and June 2019 were retrospectively identified. Safety, changes in renal function, primary treatment efficacy, and the natural history of imaging characteristics of masses postablation were examined. Forty-five patients underwent MWA during the study period. Median age was 71 years (range 31-87). Median RENAL nephrometry score was 6 (range 4-9) with mean tumor size 2.6 ± 0.7 cm. Thirty-three percent of tumors were within 4 mm of the collecting system. Median total microwave energy applied was 400 W (range 105-2600 W). There was no significant change in creatinine ( = 0.21) or glomerular filtration rate (GFR) ( = 0.09) from preoperative to postoperative day 1 (POD#1) levels. There was a statistically but not clinically significant decrease in hemoglobin from preoperative to POD#1 levels (estimated -0.06 from 7 days before procedure to POD#1, = 0.02). There was no durable change in creatinine ( = 0.16) or GFR ( = 0.72) at median follow-up of 7.5 months. There were 4 (9%) complications: three Clavien grade 1 and one Clavien grade 3 that led to loss of the kidney. Tumor size decreased postoperatively by an estimated -0.03 cm/month (range 0-1.9 cm, < 0.01). Initial technical success was 100%. Primary treatment efficacy was 94%. MWA shows promise as an alternative thermal ablative technique with excellent short-term outcomes.
为了研究微波消融（MWA）作为一种治疗小肾肿瘤的新兴技术的安全性。回顾性分析了 2015 年 3 月至 2019 年 6 月期间在一家大容量中心接受 MWA 治疗的肾肿瘤患者。检查了安全性、肾功能变化、主要治疗效果以及消融后肿瘤影像学特征的自然史。在研究期间，45 名患者接受了 MWA。中位年龄为 71 岁（范围 31-87）。中位 RENAL 肾肿瘤评分 6（范围 4-9），平均肿瘤大小 2.6±0.7cm。33%的肿瘤位于集合系统 4mm 以内。中位应用总微波能量为 400W（范围 105-2600W）。从术前到术后第 1 天（POD#1），血肌酐（=0.21）或肾小球滤过率（GFR）（=0.09）无显著变化。与术前相比，血红蛋白在 POD#1 水平（从术前 7 天到 POD#1 估计下降 0.06，=0.02）呈统计学但无临床意义的下降。在中位随访 7.5 个月时，血肌酐（=0.16）或 GFR（=0.72）无持久变化。有 4 例（9%）并发症：3 例 Clavien 1 级，1 例 Clavien 3 级，导致肾脏丢失。肿瘤大小在术后估计每月缩小 0.03cm（范围 0-1.9cm，<0.01）。初始技术成功率为 100%。主要治疗效果为 94%。MWA 作为一种替代热消融技术具有良好的短期疗效。
