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T1期肾肿瘤的射频消融与冷冻消融比较:基于证据的比较结果分析

Comparison of Radiofrequency Ablation Versus Cryoablation For T1 Renal Tumors: An Evidence-Based Analysis of Comparative Outcomes.

作者信息

Shi Hongjin, Li Jinze, Fan Zhinan, Yang Jing, Fu Shi, Wang Haifeng, Wang Jiansong, Zhang Jinsong

机构信息

Department of Urology, The Second Affiliated Hospital, Kunming Medical University, Kunming, China.

Department of Urology/Institute of Urology, West China Hospital, Sichuan University, Chengdu, China.

出版信息

Front Oncol. 2022 Apr 22;12:802437. doi: 10.3389/fonc.2022.802437. eCollection 2022.

Abstract

OBJECTIVE

To discuss the differences in the effectiveness and security for T1 renal tumors by radiofrequency ablation (RFA) and cryoablation (CA).

METHODS

We systematically searched the Cochrane Library, PubMed, Embase, CNKI databases, and Science databases, and the date was from the above database establishment to August 2021. Controlled trials on RFA and CA for T1 renal tumors were included. The meta-analysis was conducted with the Review Manager 5.4 software.

RESULTS

A total of ten studies with 2,367 patients were included in the analysis. There were no significant differences in complications (odds ratio [OR], 1.23; 95% CI, 0.80 to 1.90; p=0.35), primary technique efficacy rate (OR, 1.01; 95% CI, 0.33 to 3.14; p=0.98), changes in serum creatinine (weighted mean difference [WMD], 0.53; 95% CI, -0.50 to 1.57; p=0.31), or 5-year survival rate (hazard ratio [HR], 1.11; 95% CI, 0.41 to 3.00; p=0.84) among patients undergoing RFA and CA. However, compared with patients who underwent RFA, patients who underwent CA had a lower Local recurrence (OR: 2.25; 95% CI: 1.38 to 3.67; p = 0.001).

CONCLUSION

The analysis demonstrated that in the treatment of T1 renal tumors, CA may be associated with lower local recurrence rates. However, no differences were observed in terms of primary technique efficacy rate, 5-year survival rate, changes in serum creatinine, and complication rate between groups.

SYSTEMATIC REVIEW REGISTRATION

[https://www.crd.york.ac.uk/PROSPERO/], identifier PROSPERO (CRD42021295160).

摘要

目的

探讨射频消融(RFA)和冷冻消融(CA)治疗T1期肾肿瘤在有效性和安全性方面的差异。

方法

系统检索Cochrane图书馆、PubMed、Embase、中国知网数据库和科学数据库,检索日期为上述数据库建库至2021年8月。纳入关于RFA和CA治疗T1期肾肿瘤的对照试验。使用Review Manager 5.4软件进行荟萃分析。

结果

共纳入10项研究,2367例患者。RFA组和CA组患者在并发症(比值比[OR],1.23;95%置信区间[CI],0.80至1.90;p = 0.35)、主要技术有效率(OR,1.01;95% CI,0.33至3.14;p = 0.98)、血清肌酐变化(加权均数差[WMD],0.53;95% CI, - 0.50至1.57;p = 0.31)或5年生存率(风险比[HR],1.11;95% CI,0.41至3.00;p = 0.84)方面无显著差异。然而,与接受RFA的患者相比,接受CA的患者局部复发率较低(OR:2.25;95% CI:1.38至3.67;p = 0.001)。

结论

分析表明,在T1期肾肿瘤的治疗中,CA可能与较低的局部复发率相关。然而,两组在主要技术有效率、5年生存率、血清肌酐变化和并发症发生率方面未观察到差异。

系统评价注册

[https://www.crd.york.ac.uk/PROSPERO/],标识符PROSPERO(CRD42021295160)。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bd43/9072730/b760bdbcf965/fonc-12-802437-g001.jpg

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