Moulin Benjamin, Kammoun Tarek, Audoual Regis, Droupy Stéphane, Servois Vincent, Meria Paul, Beregi Jean Paul, Frandon Julien
Interventional Radiology Unit, Imaging Department, Institut Curie, 26 rue d'Ulm, 75005 Paris, France.
Department of Medical Imaging, Nimes University Hospital, University of Montpellier, Medical Imaging Group Nimes, Place du Pr. Robert Debré, 30029 Nîmes, France.
Cancers (Basel). 2023 Oct 28;15(21):5192. doi: 10.3390/cancers15215192.
Kidney cancer accounts for 3% of adult malignancies and is increasingly detected through advanced imaging techniques, highlighting the need for effective treatment strategies. This retrospective study assessed the safety and efficacy of a new single-probe percutaneous cryoablation system using liquid nitrogen for treating T1a renal cancers. From May 2019 to May 2022, 25 consecutive patients from two academic hospitals, with a median age of 64.8 years [IQR 59; 75.5], underwent cryoablation for 26 T1a renal tumors. These tumors had a median size of 25.3 mm [20; 30.7] and a median RENAL nephrometry score, indicating tumor complexity, of 7 [5; 9]. No major complications arose, but three non-clinically relevant perirenal hematomas were detected on post-procedure CT scans. With a median follow-up of 795 days [573; 1020], the primary local control rate at one month stood was 80.8% (21 out of 26). The five recurrent lesions, which exhibited a higher renal score ( = 0.016), were treated again using cryoablation, achieving a secondary local control rate of 100%. No patient died, and the disease-free survival rate was 92% (23 out of 25). In conclusion, single-probe percutaneous cryoablation emerges as a promising modality for managing small renal masses. Notably, recurrence rates appear influenced by RENAL nephrometry scores, suggesting a need for further research to refine the technique.
肾癌占成人恶性肿瘤的3%，并且越来越多地通过先进的成像技术被检测出来，这凸显了有效治疗策略的必要性。这项回顾性研究评估了一种使用液氮的新型单探针经皮冷冻消融系统治疗T1a期肾癌的安全性和有效性。从2019年5月到2022年5月，来自两家学术医院的25例连续患者，中位年龄为64.8岁[四分位间距59；75.5]，对26个T1a期肾肿瘤进行了冷冻消融。这些肿瘤的中位大小为25.3毫米[20；30.7]，中位RENAL肾计量评分（表明肿瘤复杂性）为7[5；9]。未出现重大并发症，但在术后CT扫描中检测到3例与临床无关的肾周血肿。中位随访795天[573；1020]，1个月时的主要局部控制率为80.8%（26例中的21例）。5个复发灶的肾计量评分较高（ = 0.016），再次使用冷冻消融治疗，二次局部控制率达到100%。无患者死亡，无病生存率为92%（25例中的23例）。总之，单探针经皮冷冻消融成为治疗小肾肿块的一种有前景的方式。值得注意的是，复发率似乎受RENAL肾计量评分影响，这表明需要进一步研究以完善该技术。
