Barjolle Irène, Ah-Thiane Loic, Frampas Eric, Karam Georges, Rigaud Jérôme, David Arthur
Department of Radiology, University Hospital (CHU) Nantes, Nantes University, Nantes, France.
Department of Radiotherapy, Western Cancer institute (ICO) René Gauducheau 44805 St-Herblain, Nantes University, Nantes, France.
Front Oncol. 2023 Oct 3;13:1235705. doi: 10.3389/fonc.2023.1235705. eCollection 2023.
Renal cryoablation displays a profile of high tolerance, including in a frail population. Cryoablation appears as a validated alternative treatment to surgery for renal tumors smaller than 4 cm. However, evidence is lacking for larger tumors, despite encouraging data for tumors up to 7 cm.
This retrospective descriptive study of a population with a stage T1b renal tumor treated by cryoablation was conducted at the Nantes University Hospital between January 2009 and July 2021. Primary endpoint was 3-year rate of local recurrence. Secondary endpoints included technical efficacy, overall and cancer-specific survivals, and safety assessment.
A total of 63 patients were analyzed. Three-year rate of local recurrence was 11.1%. Primary and secondary technical efficacies were achieved in 88.9% and 96.8% of patients, respectively, and 3-year overall and cancer-specific survival were 87.3% and 95.2%, respectively. Most patients (73%) experienced no complications, 13% of patients had minor (CIRSE grades 1 or 2) adverse effects, and 13% had severe but non-lethal (CIRSE grade 3) adverse effects. One patient died following cryoablation due to colic perforation. The most common AE (all grades) was hemorrhage (9.5%).
This study showed a good efficacy and safety of cryoablation for renal tumors up to 7 cm (T1b). Our results were consistent with a rather sparse literature and contributed to guide future recommendations about cryoablation as an alternative to surgery for T1b renal tumors.
肾冷冻消融术显示出高耐受性，包括在体弱人群中。对于小于4厘米的肾肿瘤，冷冻消融术似乎是一种经过验证的手术替代治疗方法。然而，尽管对于直径达7厘米的肿瘤有令人鼓舞的数据，但对于更大的肿瘤仍缺乏证据。
这项对2009年1月至2021年7月间在南特大学医院接受冷冻消融治疗的T1b期肾肿瘤患者群体的回顾性描述性研究。主要终点是3年局部复发率。次要终点包括技术疗效、总生存率和癌症特异性生存率以及安全性评估。
共分析了63例患者。3年局部复发率为11.1%。分别有88.9%和96.8%的患者实现了主要和次要技术疗效，3年总生存率和癌症特异性生存率分别为87.3%和95.2%。大多数患者（73%）未出现并发症，13%的患者有轻微（CIRSE 1级或2级）不良反应，13%的患者有严重但非致命（CIRSE 3级）不良反应。1例患者在冷冻消融术后因结肠穿孔死亡。最常见的不良事件（所有级别）是出血（9.5%）。
本研究表明冷冻消融术对直径达7厘米（T1b）的肾肿瘤具有良好的疗效和安全性。我们的结果与相当稀少的文献一致，并有助于指导未来关于冷冻消融术作为T1b肾肿瘤手术替代方法的建议。
