Department of Imaging, Service d'Imagerie, Lyon Sud Hospital, University Hospital of Lyon, Hospices Civils de Lyon, Lyon, France.
Claude-Bernard University of Lyon, 165 chemin du Grand Revoyet, 69495, Pierre-Bénite, Lyon, France.
Cardiovasc Intervent Radiol. 2022 May;45(5):656-664. doi: 10.1007/s00270-022-03079-1. Epub 2022 Mar 10.
To retrospectively investigate the safety and oncological outcomes of cryoablation performed on residual/recurring renal cell carcinoma (RCC) in the ipsilateral kidney following partial nephrectomy (PN).
Data dealing with patients', RCC, procedure (including the length of the hospital stay), and follow-up (technical efficacy [TE], local tumor progression-free survival [LTPFS], disease-free survival [DFS], metastasis-free survival [MFS], cancer-specific survival (CSS), and overall survival [OS]) were retrospectively collected and analyzed.
Between January 2008 and November 2020, 21 consecutive patients (17 [81%] men; 4 [19%] women; median age 68 years; range 43-82) underwent cryoablation due to residual/recurring RCC in the PN site (15 patients) or de-novo RCC (6 patients) in the ipsilateral kidney. Median tumor size was 2.2 cm (mean 2.3 cm; range 0.8-4; interquartile range [IQR] 1.9-3). There were two (2/21; 10%) minor self-limiting hemorrhagic complications, both occurring in the group of patients with RCC in the PN site. Median hospital stay was 2 days (mean 2.1; range 1-5; IQR 2-2). TE was 100% (21/21 patients), and 10-year estimates of LTPFS, MFS and DFS were 74.1% (95% confidence intervals [CI] 56.8-96.7%), 36.4% (95% CI 14.2-93.8%), and 43.5% (95% CI 21.9-86.4%), respectively. CSS and OS were 100% at the last available follow-up (median 56 months; mean 67.4; range: 12-147; IQR:34-95).
Cryoablation in patients with residual/recurring RCC following PN is safe and results in high 10-year estimates of LTPFS.
回顾性分析肾部分切除术(PN)后同侧肾脏残余/复发性肾细胞癌(RCC)行冷冻消融术的安全性和肿瘤学结果。
回顾性收集患者、RCC、手术(包括住院时间)和随访(技术疗效[TE]、局部肿瘤无进展生存期[LTPFS]、无病生存期[DFS]、无转移生存期[MFS]、癌症特异性生存期[CSS]和总生存期[OS])相关数据并进行分析。
2008 年 1 月至 2020 年 11 月,21 例连续患者(17 例[81%]为男性;4 例[19%]为女性;中位年龄 68 岁;范围 43-82 岁)因 PN 部位残余/复发性 RCC(15 例患者)或同侧肾脏新发 RCC(6 例患者)行冷冻消融术。中位肿瘤大小为 2.2cm(平均 2.3cm;范围 0.8-4cm;四分位距[IQR] 1.9-3cm)。有 2 例(2/21;10%)轻微自限性出血性并发症,均发生在 PN 部位 RCC 组患者中。中位住院时间为 2 天(平均 2.1 天;范围 1-5 天;IQR 2-2 天)。TE 为 100%(21/21 例患者),10 年 LTPFS、MFS 和 DFS 估计值分别为 74.1%(95%置信区间[CI] 56.8-96.7%)、36.4%(95% CI 14.2-93.8%)和 43.5%(95% CI 21.9-86.4%)。在最后一次可获得的随访中,CSS 和 OS 均为 100%(中位随访时间 56 个月;平均 67.4 个月;范围:12-147 个月;IQR:34-95 个月)。
PN 后残余/复发性 RCC 患者行冷冻消融术安全,10 年 LTPFS 估计值高。