Division of Medical Informatics, Okayama University Hospital, 2-5-1, Shikata-cho, Kita-ku, Okayama, Japan.
Department of Radiology, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, 2-5-1, Shikata-cho, Kita-ku, Okayama, Japan.
Int J Clin Oncol. 2022 Oct;27(10):1589-1595. doi: 10.1007/s10147-022-02224-7. Epub 2022 Aug 9.
We prospectively evaluated the safety and efficacy of percutaneous cryoablation combined with transcatheter renal arterial embolization for the treatment of tumors ≥ 3 cm in diameter.
We included patients aged ≥ 20 years with histologically proven renal cell carcinoma with a tumor diameter ≥ 3 cm who were inoperable or refused surgery. Prior to ablation, transcatheter arterial embolization was performed using a mixture of absolute ethanol and iodized oil. All cryoablation procedures were performed percutaneously under computed tomography fluoroscopy guidance. The primary endpoint was safety, which was evaluated for adverse events using CTCAE version 4.0. The secondary endpoint was survival; overall survival, progression-free survival, and cancer-specific survival were calculated.
From October 2013 to March 2016, 19 patients (mean age, 75 ± 13 years; 5 women, 14 men) were prospectively enrolled. The mean tumor diameter was 3.9 ± 0.7 (range 3.1-5.3) cm. Four grade 3 hematologic adverse events occurred, while no symptomatic grade ≥ 3 events occurred. The median follow-up period was 68 (range 52-84) months. During the follow-up period, two patients developed local tumor progression at 3 and 42 months after the initial ablative procedure; no patient showed distant metastasis. Two patients died from causes other than RCC. Overall survival, progression-free survival, and cause-specific survival were 100%, 95%, and 100% at 3 years, and 95%, 84%, and 100% at 5 years, respectively.
Percutaneous cryoablation combined with prior TAE for the treatment of tumors ≥ 3 cm in diameter was safe and achieved favorable survival.
我们前瞻性评估了经皮冷冻消融联合经导管肾动脉栓塞治疗直径≥3cm 肿瘤的安全性和有效性。
我们纳入了年龄≥20 岁、经组织学证实患有肾细胞癌且肿瘤直径≥3cm 且无法手术或拒绝手术的患者。在消融前，使用无水乙醇和碘化油混合物进行经导管动脉栓塞。所有冷冻消融程序均在 CT 透视引导下经皮进行。主要终点是安全性，使用 CTCAE 第 4.0 版评估不良事件。次要终点是生存；计算总生存率、无进展生存率和癌症特异性生存率。
2013 年 10 月至 2016 年 3 月，前瞻性纳入 19 名患者（平均年龄 75±13 岁；5 名女性，14 名男性）。平均肿瘤直径为 3.9±0.7（范围 3.1-5.3）cm。发生了 4 例 3 级血液学不良事件，而没有发生任何有症状的≥3 级事件。中位随访时间为 68（范围 52-84）个月。在随访期间，2 例患者在初始消融后 3 和 42 个月时发生局部肿瘤进展；无患者出现远处转移。2 例患者因肾癌以外的原因死亡。3 年时总生存率、无进展生存率和癌症特异性生存率分别为 100%、95%和 100%，5 年时分别为 95%、84%和 100%。
经皮冷冻消融联合 TAE 治疗直径≥3cm 的肿瘤是安全的，可获得良好的生存。
