Yu Jie, Yu Xiao-Ling, Cheng Zhi-Gang, Hu Bing, Han Zhi-Yu, Liu Fang-Yi, Hu Zhi-Quan, Wang Hui, Dong Jun, Pan Jie, Yang Bo, Sai Xiaoyong, Guo Ai-Tao, Liang Ping
Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing, China.
State Key Laboratory of Kidney Disease, The Chinese PLA General Hospital, Beijing, China.
Int J Hyperthermia. 2020;37(1):827-835. doi: 10.1080/02656736.2020.1779356.
Imaging-guided percutaneous microwave ablation (MWA) with high thermal efficiency comprises rapid, successful management of small renal cell carcinomas (RCCs) in selected patients. Ultrasound Committee of Chinese Medical Association, Interventional Oncology Committee of Chinese Research Hospital Association developed evidence-based guidelines for MWA of RCCs after systematically reviewing the 1969-2019 literature. Systematic reviews, meta-analyses, randomized controlled trials, cohort, and case-control studies reporting MWA of RCCs were included and levels of evidence assessed. Altogether, 146 articles were identified, of which 35 reported percutaneous MWA for T1a RCCs and 5 articles for T1b RCCs. Guidelines were established based on indications, techniques, safety, and effectiveness of MWA for RCCs, with the goal of standardizing imaging-guided percutaneous MWA treatment of RCCs. Key points Microwave ablation is recommended for managing small renal cell carcinoma in selected patients. Imaging protocols are tailored based on the procedural plan, guidance, and evaluation. Patient's selection evaluation, updated technique information, clinical efficacy, and complications are recommended to standardize management. A joint task force (multidisciplinary team) summarized the key elements of the standardized report.
具有高热效率的影像引导下经皮微波消融(MWA)包括对部分患者的小肾癌(RCC)进行快速、成功的治疗。中华医学会超声医学分会、中国研究型医院学会介入肿瘤学专业委员会在系统回顾1969年至2019年文献后,制定了肾癌微波消融的循证指南。纳入了报告肾癌微波消融的系统评价、荟萃分析、随机对照试验、队列研究和病例对照研究,并评估证据水平。共识别出146篇文章,其中35篇报告了经皮微波消融治疗T1a期肾癌,5篇报告了经皮微波消融治疗T1b期肾癌。基于肾癌微波消融的适应症、技术、安全性和有效性制定了指南,目的是规范影像引导下经皮微波消融治疗肾癌。要点:推荐微波消融治疗部分小肾癌患者。根据操作计划、引导和评估定制影像方案。建议进行患者选择评估、更新技术信息、临床疗效和并发症评估以规范治疗。一个联合工作组(多学科团队)总结了标准化报告的关键要素。