Department of Radiology, Mayo Clinic, 200 First St SW, Rochester, MN 55905.
AJR Am J Roentgenol. 2021 Jul;217(1):152-156. doi: 10.2214/AJR.20.22861. Epub 2021 Apr 14.
The purpose of this study was to assess the feasibility, safety, and efficacy of percutaneous cryoablation for the treatment of lymph node metastases. In this single-institution retrospective study 55 patients were identified who underwent CT-guided cryoablation of metastatic lymph nodes between November 2006 and September 2019. Patient demographics, disease characteristics, and procedural details were recorded. The primary endpoints were technical success and major complications. The secondary endpoints were time to local and time to distant progression. Complications were graded according to the Society of Interventional Radiology consensus guidelines. The study sample comprised 55 patients (42 men, 13 women; mean age 64 ± 12 years) who underwent 61 cryoablation procedures to treat 65 lymph node metastases. Targeted nodes measured 1.7 ± 1.2 cm in mean short-axis diameter. Technical success was achieved in 60 of 61 cryoablation procedures (98%). Adjunctive maneuvers performed to protect adjacent structures included hydrodissection ( = 40), ureteral stenting ( = 3), and neural monitoring ( = 3). There were two Society of Interventional Radiology major complications (3%): pneumothorax ( = 1) and bleeding ( = 1). Local tumor control was achieved in treatment of 53 of 65 (82%) nodal metastases within a median of 25 months (range, 1-121 months) of follow-up. Local progression occurred in 12 of 65 cases (18%); the median time to recurrence was 11 months. Percutaneous cryoablation of nodal metastases is feasible and safe. Further investigation is warranted to assess the long-term efficacy of this technique and to define its role in oncologic care.
本研究旨在评估经皮冷冻消融治疗淋巴结转移的可行性、安全性和疗效。在这项单中心回顾性研究中，共确定了 55 例于 2006 年 11 月至 2019 年 9 月期间接受 CT 引导下冷冻消融转移性淋巴结的患者。记录了患者的人口统计学、疾病特征和手术细节。主要终点是技术成功率和主要并发症。次要终点是局部和远处进展的时间。并发症根据介入放射学学会共识指南进行分级。研究样本包括 55 例患者（42 例男性，13 例女性；平均年龄 64 ± 12 岁），共进行了 61 次冷冻消融手术以治疗 65 个淋巴结转移。目标淋巴结的短轴直径平均为 1.7 ± 1.2 cm。61 次冷冻消融术中有 60 次达到技术成功（98%）。为保护邻近结构而进行的辅助操作包括水分离术（40 例）、输尿管支架置入术（3 例）和神经监测（3 例）。有 2 例介入放射学学会主要并发症（3%）：气胸（1 例）和出血（1 例）。在中位随访 25 个月（范围 1-121 个月）内，65 个淋巴结转移中有 53 个（82%）达到局部肿瘤控制。12 个（18%）病例出现局部进展，中位复发时间为 11 个月。经皮冷冻消融治疗淋巴结转移是可行且安全的。需要进一步研究来评估该技术的长期疗效，并确定其在肿瘤治疗中的作用。
