RENAL、PADUA 和 NePhRO 评分与 CT 引导下微波消融肾肿瘤患者并发症和结局的相关性。

Correlations of RENAL, PADUA and NePhRO Scores With Complications and Outcomes in Patients After CT-Guided Microwave Ablation of Renal Tumors.

出版信息

Altern Ther Health Med. 2022 Jan;28(1):92-99.

Abstract

OBJECTIVE

This retrospective study aimed to access the correlations of RENAL, PADUA and NePhRO scores with operative complications, chronic kidney disease (CKD) upstaging, and oncologic outcomes after CT-guided percutaneous Microwave Ablation (MWA) of renal tumors in order to determine their status as independent predictors of outcomes after MWA. This study also aimed to generally evaluate the efficacy of MWA in treating renal tumors.

METHODS

From January 2017 to December 2019, 18 patients with 27 renal tumors who had undergone simultaneous biopsy and MWA were recruited in this single-center retrospective study. Data collection included tumor characteristics, procedural protocols, complications, CKD upstaging data, local tumor control data and overall survival. All lesions were evaluated using RENAL, PADUA and NePhRO scores, and further analysis was performed to determine whether the scores were correlated with operative complications, CKD upstaging, local tumor control and overall survival.

RESULTS

The minor and major complication rates were 16.7% and 0%, respectively. Two patients with solitary kidney experienced CKD upstaging. Local tumor recurrence was identified in one type of tumor (3.7%) in the first year of follow-up. L. parameter (P = .031), longitudinal (polar) location score (P = .011), Ne. parameter (P = .036), number of kidneys (P = .005), and number of lesions (P = .008), were predictive factors significantly associated with the occurrence of complications. Besides, CKD upstaging was associated with A. parameter (P = .032) and urinary collecting system score (P = .028). RENAL, PADUA, and NePhRO scores were significantly correlated with complications, overall survival, and CKD upstaging, respectively (P < .05).

CONCLUSION

CT-guided percutaneous MWA was found to be a valuable alternative in the treatment of renal tumors for selected patients. Furthermore, RENAL, PADUA and NePhRO scores were not independent predictors of outcomes of MWA.

摘要

目的

本回顾性研究旨在评估 RENAL、PADUA 和 NePhRO 评分与 CT 引导下经皮微波消融（MWA）治疗肾肿瘤术后手术并发症、慢性肾脏病（CKD）升级和肿瘤学结果的相关性，以确定其作为 MWA 后结局的独立预测因子的地位。本研究还旨在评估 MWA 治疗肾肿瘤的总体疗效。

方法

本单中心回顾性研究于 2017 年 1 月至 2019 年 12 月共纳入 18 例 27 个肾肿瘤患者，这些患者均同时接受了活检和 MWA。数据收集包括肿瘤特征、操作方案、并发症、CKD 升级数据、局部肿瘤控制数据和总生存数据。所有病变均采用 RENAL、PADUA 和 NePhRO 评分进行评估，并进一步分析评分与手术并发症、CKD 升级、局部肿瘤控制和总生存的相关性。

结果

轻微并发症和严重并发症的发生率分别为 16.7%和 0%。2 例孤立肾患者发生 CKD 升级。在随访的第一年，发现 1 种肿瘤（3.7%）出现局部肿瘤复发。L 参数（P =.031）、纵向（极向）位置评分（P =.011）、Ne 参数（P =.036）、肾脏数量（P =.005）和病变数量（P =.008）是与并发症发生显著相关的预测因素。此外，CKD 升级与 A 参数（P =.032）和尿路收集系统评分（P =.028）相关。RENAL、PADUA 和 NePhRO 评分与并发症、总生存和 CKD 升级分别显著相关（P <.05）。