Osman Filzah Hanis, Chan Vinson Wai-Shun, Breen David J, King Alexander, Nielsen Tommy Kjærgaard, Garnon Julien, Alcorn Des, Lagerveld Brunolf, Graumann Ole, Keeley Francis Xavier, Walkden Miles, de Kerviler Éric, Wah Tze Min
School of Medicine, Faculty of Medicine and Health, University of Leeds, Leeds LS2 9JT, UK.
Leeds Institute of Medical Research, University of Leeds, Leeds LS2 9JT, UK.
Cancers (Basel). 2023 Jun 24;15(13):3322. doi: 10.3390/cancers15133322.
This study aims to evaluate the safety, efficacy, and renal function preservation of percutaneous cryoablation (PCA) for small renal masses (SRMs) in inherited RCC syndromes. Patients with inherited T1N0M0 RCCs (<7 cm) undergoing PCA from 2015 to 2021 were identified from the European Registry for Renal Cryoablation (EuRECA). The primary outcome was local recurrence-free survival (LRFS). The secondary outcomes included technical success, peri-operative outcomes, and other oncological outcomes estimated using the Kaplan-Meier method. Simple proportions, chi-squared tests, and -tests were used to analyse the peri-operative outcomes. A total of 68 sessions of PCA were performed in 53 patients with RCC and 85 tumours were followed-up for a mean duration of 30.4 months (SD ± 22.0). The overall technical success rate was 99%. The major post-operative complication rate was 1.7%. In total, 7.4% (2/27) of patients had >25% reduction in renal function. All oncological events were observed in VHL patients. Estimated 5-year LRFS, metastasis-free survival, cancer-specific survival, and overall survival were 96.0% (95% CI 75-99%), 96.4% (95% CI 77-99%), 90.9% (95% CI 51-99%), and 90.9% (95% CI 51-99%), respectively. PCA of RCCs for patients with hereditary RCC SRMs appears to be safe, offers low complication rates, preserves renal function, and achieves good oncological outcomes.
本研究旨在评估经皮冷冻消融术（PCA）治疗遗传性肾细胞癌（RCC）综合征中小肾肿块（SRM）的安全性、有效性及肾功能保留情况。从欧洲肾冷冻消融登记处（EuRECA）中确定2015年至2021年期间接受PCA治疗的遗传性T1N0M0期RCC（<7 cm）患者。主要结局为无局部复发生存期（LRFS）。次要结局包括技术成功率、围手术期结局以及使用Kaplan-Meier方法估计的其他肿瘤学结局。采用简单比例、卡方检验和t检验分析围手术期结局。对53例RCC患者共进行了68次PCA治疗，85个肿瘤接受了平均30.4个月（标准差±22.0）的随访。总体技术成功率为99%。主要术后并发症发生率为1.7%。共有7.4%（2/27）的患者肾功能下降>25%。所有肿瘤学事件均在VHL患者中观察到。估计5年LRFS、无转移生存期、癌症特异性生存期和总生存期分别为96.0%（95%CI 75-99%）、96.4%（95%CI 77-99%）、90.9%（95%CI 51-99%）和90.9%（95%CI 51-99%）。对于遗传性RCC SRM患者，RCC的PCA似乎是安全的，并发症发生率低，能保留肾功能，并取得良好的肿瘤学结局。
