Rossebo Annika E, Zlevor Annie M, Knott Emily A, Mao Lu, Couillard Allison B, Ziemlewicz Timothy J, Hinshaw J Louis, Abel E Jason, Lubner Meghan G, Knavel Koepsel Erica M, Wells Shane A, Stratchko Lindsay M, Laeseke Paul F, Lee Fred T
From the Departments of Radiology (A.E.R., A.M.Z., A.B.C., T.J.Z., J.L.H., E.J.A., M.G.L., E.M.K.K., S.A.W., L.M.S., P.F.L., F.T.L.), Biomedical Engineering (A.E.R., F.T.L.), Biostatistics and Medical Informatics (L.M.), and Urology (J.L.H., E.J.A., F.T.L.), University of Wisconsin-Madison School of Medicine and Public Health, 600 Highland Ave, E3/378 Clinical Science Center, Madison, WI 53792-3252; and Cleveland Clinic Lerner College of Medicine, Cleveland, Ohio (E.A.K.).
Radiol Imaging Cancer. 2024 Mar;6(2):e230080. doi: 10.1148/rycan.230080.
Purpose To determine if microwave ablation (MWA) of retroperitoneal tumors can safely provide high rates of local tumor control. Materials and Methods This retrospective study included 19 patients (median age, 65 years [range = 46-78 years]; 13 [68.4%] men and six [31.6%] women) with 29 retroperitoneal tumors treated over 22 MWA procedures. Hydrodissection (0.9% saline with 2% iohexol) was injected in 17 of 22 (77.3%) procedures to protect nontarget anatomy. The primary outcomes evaluated were local tumor progression (LTP) and complication rates. Oncologic outcomes, including overall survival (OS), progression-free survival (PFS), and treatment-free interval (TFI), were examined as secondary outcome measures. Results Median follow-up was 18 months (range = 0.5-113). Hydrodissection was successful in displacing nontarget anatomy in 16 of 17 (94.1%) procedures. The LTP rate was 3.4% (one of 29; 95% CI: 0.1, 17.8) per tumor and 5.3% (one of 19; 95% CI: 0.1, 26.0) per patient. The overall complication rate per patient was 15.8% (three of 19), including two minor complications and one major complication. The OS rate at 1, 2, and 3 years was 81.8%, 81.8%, and 72.7%, respectively, with a median OS estimated at greater than 7 years. There was no evidence of a difference in OS ( = .34) and PFS ( = .56) between patients with renal cell carcinoma (six of 19 [31.6%]) versus other tumors (13 of 19 [68.4%]) and patients treated with no evidence of disease (15 of 22 [68.2%]) versus patients with residual tumors (seven of 22 [31.8%]). Median TFI was 18 months (range = 0.5-108). Conclusion Treatment of retroperitoneal tumors with MWA combined with hydrodissection provided high rates of local control, prolonged systemic therapy-free intervals, and few serious complications. Ablation Techniques (ie, Radiofrequency, Thermal, Chemical), Retroperitoneum, Microwave Ablation, Hydrodissection © RSNA, 2024.
目的 确定微波消融（MWA）治疗腹膜后肿瘤能否安全地实现较高的局部肿瘤控制率。材料与方法 本回顾性研究纳入了19例患者（中位年龄65岁[范围 = 46 - 78岁]；男性13例[68.4%]，女性6例[31.6%]），其29个腹膜后肿瘤接受了22次MWA治疗。22次治疗中的17次（77.3%）进行了水分离（0.9%生理盐水加2%碘海醇）以保护非靶区解剖结构。评估的主要结局为局部肿瘤进展（LTP）和并发症发生率。将包括总生存期（OS）、无进展生存期（PFS）和无治疗间期（TFI）在内的肿瘤学结局作为次要结局指标进行检查。结果 中位随访时间为18个月（范围 = 0.5 - 113个月）。17次治疗中的16次（94.1%）水分离成功地推移了非靶区解剖结构。每个肿瘤的LTP发生率为3.4%（29个中的1个；95%CI：0.1，17.8），每位患者的LTP发生率为5.3%（19个中的1个；95%CI：0.1，26.0）。每位患者的总体并发症发生率为15.8%（19个中的3个），包括2例轻微并发症和1例严重并发症。1年、2年和3年的OS率分别为81.8%、81.8%和72.7%，估计中位OS大于7年。肾细胞癌患者（19个中的6个[31.6%]）与其他肿瘤患者（19个中的13个[68.4%]）以及无疾病证据患者（22个中的15个[68.2%]）与有残留肿瘤患者（22个中的7个[31.8%]）之间在OS（P = 0.34）和PFS（P = 0.56）方面均无差异证据。中位TFI为18个月（范围 = 0.5 - 108个月）。结论 MWA联合水分离治疗腹膜后肿瘤可实现较高的局部控制率、延长无全身治疗间期且严重并发症较少。消融技术（即射频、热、化学），腹膜后，微波消融，水分离 © RSNA，2024
