Nagata Chisami, Fujimori Masashi, Yamanaka Takashi, Sugino Yuichi, Matsushita Naritaka, Kishi Seiya, Fukui Hikari, Omori Yuki, Nishikawa Kohei, Sakuma Hajime
Department of Radiology, Mie University School of Medicine, Japan.
Department of Nephro-Urologic Surgery and Andrology, Mie University School of Medicine, Japan.
Interv Radiol (Higashimatsuyama). 2022 Oct 7;7(3):85-92. doi: 10.22575/interventionalradiology.2021-0032. eCollection 2022 Nov 4.
To retrospectively evaluate the treatment outcomes of thermal ablation for renal metastatic tumors.
Thirteen consecutive patients with small renal metastatic tumors (≤3 cm), who underwent thermal ablation between 2009 and 2020, were included in this study. Eight patients had extra-renal tumors during renal ablation. The primary tumors were adenoid cystic carcinoma in four patients, lung cancer in three, hemangiopericytoma in three, leiomyosarcoma in two, and thyroid cancer in one. The therapeutic effects, safety, survival rate, prognostic factor, and renal function were evaluated.
We performed 18 ablation sessions (cryoablation, n = 13; radiofrequency ablation, n = 5) on 19 renal metastases with a mean diameter of 1.7 cm, which resulted in a primary technique efficacy rate of 100% without procedure-related deaths or major complications. Renal function significantly declined 6 months after ablation ( = 0.0039). During the mean follow-up period of 31.2 ± 22.4 months (range, 2.7-71.4 months), one patient had local tumor progression at 11.9 months following radiofrequency ablation. The overall survival rates at 1 and 3 years after ablation were 76.9% (95% confidence interval [CI], 54.0%-99.8%) and 59.3% (95% CI, 31.3%-87.3%), respectively. Tumor size ≥ 2 cm ( = 0.02) and metastasis from non-small cell lung cancer ( = 0.001) were significant worse prognostic factors in univariate analysis, and metastasis from non-small cell lung cancer ( = 0.01) was significant in multivariate analysis.
Percutaneous thermal ablation for small renal metastases is safe and feasible and can control local tumors.
回顾性评估肾转移性肿瘤热消融的治疗效果。
本研究纳入了2009年至2020年间连续13例接受热消融治疗的小肾转移性肿瘤(≤3 cm)患者。8例患者在肾消融期间伴有肾外肿瘤。4例患者的原发肿瘤为腺样囊性癌,3例为肺癌,3例为血管外皮细胞瘤,2例为平滑肌肉瘤,1例为甲状腺癌。评估了治疗效果、安全性、生存率、预后因素和肾功能。
我们对19个平均直径为1.7 cm的肾转移瘤进行了18次消融治疗(冷冻消融13例,射频消融5例),主要技术有效率为100%,无手术相关死亡或严重并发症。消融后6个月肾功能显著下降(P = 0.0039)。在平均31.2±22.4个月(范围2.7 - 71.4个月)的随访期内,1例患者在射频消融后11.9个月出现局部肿瘤进展。消融后1年和3年的总生存率分别为76.9%(95%置信区间[CI],54.0% - 99.8%)和59.3%(95% CI,31.3% - 87.3%)。单因素分析中,肿瘤大小≥2 cm(P = 0.02)和非小细胞肺癌转移(P = 0.001)是显著较差的预后因素,多因素分析中非小细胞肺癌转移(P = 0.01)具有显著性。
经皮热消融治疗小肾转移瘤安全可行,可控制局部肿瘤。