Jasinski Milosz, Bielinska Marta, Siekiera Jerzy, Kamecki Krzysztof, Salagierski Maciej
Department of Urology, Collegium Medicum, University of Zielona Góra, Zyty 28, 65-046 Zielona Góra, Poland.
Department of Urology, Institute of Oncology, Romanowskiej 2, 85-796 Bydgoszcz, Poland.
Cancers (Basel). 2023 Jan 14;15(2):518. doi: 10.3390/cancers15020518.
Over the recent years, the progress in imaging techniques has led to an increased detection of kidney tumours, including small renal masses. While surgery is still the standard of care, there is a growing interest in minimally invasive methods. Ultrasound (US)-guided percutaneous ablation is particularly attractive because it is a safe and relatively simple procedure. In this study, we investigated the success of percutaneous radiofrequency ablation (RFA) in relation to kidney tumour diameter and location. Between August 2016 and September 2021, 253 patients with 259 renal tumours underwent US-guided RFA as a primary treatment in our institution. A total of 67 patients were excluded from this study. Abdominal computed tomography (CT) and tumour biopsy were performed before the procedure. Patients were followed with contrast-enhanced CT, the average follow-up time was 28 months. The studied group was composed of 186 patients with 191 renal tumours-only biopsy-confirmed renal cancers were included. During the follow-up, 46 cases of residual disease and 4 cases of local progression were found. There was a significant correlation between tumour size and the ablation success rate. The success rate was 73.5% and 87.6% for lesions ≤25 mm, 94.6% for lesions ≤25 mm and exophytic, 79.1% for lesions 26-30 mm and 84.4% for lesions 26-30 mm and exophytic, respectively. Four Clavien-Dindo grade ≥2 complications were observed. US-guided percutaneous RFA of T1a renal cancers is safe and well-tolerated. Its effectiveness depends on tumour size, with best results for exophytic lesions smaller than 3 cm. Most of the recurrent or residual tumours can be successfully re-treated with US-guided percutaneous RFA.
近年来，成像技术的进步使得肾脏肿瘤（包括小肾肿块）的检出率有所提高。虽然手术仍是标准治疗方法，但人们对微创方法的兴趣与日俱增。超声（US）引导下的经皮消融术尤其具有吸引力，因为它是一种安全且相对简单的手术。在本研究中，我们调查了经皮射频消融（RFA）的成功率与肾脏肿瘤直径和位置的关系。2016年8月至2021年9月期间，253例患有259个肾肿瘤的患者在我们机构接受了US引导下的RFA作为主要治疗。共有67例患者被排除在本研究之外。术前进行了腹部计算机断层扫描（CT）和肿瘤活检。患者接受对比增强CT随访，平均随访时间为28个月。研究组由186例患有191个肾肿瘤（仅包括活检确诊的肾癌）的患者组成。随访期间，发现46例残留疾病和4例局部进展。肿瘤大小与消融成功率之间存在显著相关性。≤25mm的病灶成功率为73.5%，≤25mm且为外生性的病灶成功率为87.6%，26 - 30mm的病灶成功率为79.1%，26 - 30mm且为外生性的病灶成功率为84.4%。观察到4例Clavien-Dindo分级≥2级的并发症。US引导下T1a期肾癌的经皮RFA安全且耐受性良好。其有效性取决于肿瘤大小，对于小于3cm的外生性病灶效果最佳。大多数复发或残留肿瘤可以通过US引导下的经皮RFA成功再次治疗。
