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肾部分切除术后同侧肾复发肾细胞癌行经皮冷冻消融术的安全性和肿瘤学结局。

Safety and Oncologic Outcomes of Percutaneous Cryoablation of Renal Cell Carcinoma Recurrences in the Ipsilateral Kidney Following Partial Nephrectomy.

机构信息

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.

出版信息

Cardiovasc Intervent Radiol. 2022 May;45(5):656-664. doi: 10.1007/s00270-022-03079-1. Epub 2022 Mar 10.

Abstract

PURPOSE

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).

MATERIALS AND METHODS

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.

RESULTS

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).

CONCLUSION

Cryoablation in patients with residual/recurring RCC following PN is safe and results in high 10-year estimates of LTPFS.

摘要

目的

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。

材料与方法

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。

结果

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)。

结论

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。

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