Nagata Shoma, Matsui Yusuke, Tomita Koji, Uka Mayu, Kawabata Takahiro, Umakoshi Noriyuki, Munetomo Kazuaki, Kawada Maria, Iguchi Toshihiro, Hiraki Takao
Department of Radiology, Gifu University, Gifu, Japan.
Department of Radiology, Okayama University Hospital, Okayama, Japan.
Minim Invasive Ther Allied Technol. 2025 Feb;34(1):15-23. doi: 10.1080/13645706.2024.2354332. Epub 2024 May 17.
This study aimed to assess the outcomes of percutaneous cryoablation (PCA) for renal cell carcinomas (RCCs) contacting critical organs without intervening fat tissue.
Twenty-three patients with 24 RCCs (mean size, 28.8 mm) contacting critical organs on preprocedural images were included. The organ displacement techniques, technical success, efficacy, and adverse events per Clavien-Dindo classification were retrospectively reviewed.
The organs contacting the RCCs included the colon ( = 16), pancreas ( = 3), duodenum ( = 3), small intestine ( = 1), and stomach ( = 1). In all procedures, hydrodissection was conducted, and probe traction was additionally utilized in one to displace organs. Two procedures were terminated with an insufficient ice-ball margin (<6 mm) due to recurring proximity of the colon or thermal sink effect by renal hilar vessels, yielding a technical success rate of 91.6% (22/24). No severe adverse events were noted. All patients were alive without any metastases during a median follow-up of 34.4 months. The primary and secondary technical efficacy rates were 91.6% (22/24) and 95.8% (23/24) of tumors, respectively.
PCA can be a valid option for RCCs contacting critical organs with a good safety profile and sufficient technical efficacy.
本研究旨在评估经皮冷冻消融术（PCA）治疗与关键器官相邻且无脂肪组织间隔的肾细胞癌（RCC）的疗效。
纳入23例患者的24个RCC（平均大小28.8mm），这些RCC在术前影像上与关键器官相邻。回顾性分析了器官移位技术、技术成功率、疗效以及根据Clavien-Dindo分类的不良事件。
与RCC相邻的器官包括结肠（n = 16）、胰腺（n = 3）、十二指肠（n = 3）、小肠（n = 1）和胃（n = 1）。在所有手术中均进行了水分离，其中1例额外采用了探头牵引以移位器官。2例手术因结肠反复靠近或肾门血管的热沉效应导致冰球边缘不足（<6mm）而终止，技术成功率为91.6%（22/24）。未观察到严重不良事件。在中位随访34.4个月期间，所有患者均存活，无任何转移。肿瘤的主要和次要技术有效率分别为91.6%（22/24）和95.8%（23/24）。
PCA对于与关键器官相邻的RCC可能是一种有效的选择，具有良好的安全性和足够的技术疗效。
