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影响超声引导下肾肿瘤射频消融治疗效果的因素。

Factors that Affect Outcome of Ultrasound-Guided Radiofrequency Ablation of Renal Masses.

机构信息

Department of Radiology, Karolinska University Hospital, 141 86 Stockholm, Sweden.

CLINTEC (The Department of Clinical Science, Intervention and Technology), Karolinska University, 141 86 Stockholm, Sweden.

出版信息

Curr Oncol. 2024 Sep 10;31(9):5318-5329. doi: 10.3390/curroncol31090392.

Abstract

The purpose of this study was to examine the factors influencing the efficacy and safety of the ultrasound-guided radiofrequency ablation of renal tumors. Between January 2010 and December 2018, 159 patients with renal tumors treated with ultrasound-guided percutaneous radiofrequency ablation at our institution were included in this study. Biopsies were performed for histopathological analysis prior to each ablation. Patients underwent computed tomography follow-ups at 3, 6, and 12 months and were subsequently observed on an annual basis. The primary efficacy rate (i.e., residual tumor), local tumor progression, morbidity and mortality, and possible outcome predictors (age, body mass index, gender, tumor size, tumor location, tumor characteristics, ablation temperature, and reported technical problems) were analyzed using binary logistic regression. At the first follow-up, 3 months after ablation, the primary efficacy rate was 79%. Two percent of the tumors showed local tumor progression during the whole follow-up. Tumor proximity to the collecting system and the final temperature in the ablation region were associated with the occurrence of residual tumor (OR = 2.85, = 0.019 and OR = 4.23, = 0.006, respectively). A similar trend was shown for tumors larger than 3 cm ( = 0.066). A short distance to the collecting system and the ablation temperature were significantly related to the occurrence of residual tumors after the radiofrequency ablation of small renal masses. The ultrasound guidance used in our study has a lower primary efficacy rate than the computed tomography guidance used in comparable studies.

摘要

本研究旨在探讨影响超声引导下射频消融治疗肾肿瘤疗效和安全性的因素。2010 年 1 月至 2018 年 12 月,我院对 159 例肾肿瘤患者进行了超声引导下经皮射频消融治疗,所有患者均进行了术前活检以进行组织病理学分析。患者分别在消融前、消融后 3、6 和 12 个月进行 CT 随访,随后每年进行一次随访。采用二项逻辑回归分析主要疗效(即残留肿瘤)、局部肿瘤进展、发病率和死亡率以及可能的预后预测因素(年龄、体重指数、性别、肿瘤大小、肿瘤位置、肿瘤特征、消融温度和报告的技术问题)。在第一次随访中,即消融后 3 个月,主要疗效(即残留肿瘤)率为 79%。在整个随访期间,有 2%的肿瘤出现局部肿瘤进展。肿瘤与集合系统的临近程度和消融区域的最终温度与残留肿瘤的发生有关(OR = 2.85, = 0.019 和 OR = 4.23, = 0.006)。肿瘤大于 3cm 时也存在类似趋势( = 0.066)。对于较小的肾肿瘤,与集合系统的接近程度和消融温度与射频消融后残留肿瘤的发生显著相关。与相似研究相比,本研究中使用的超声引导的主要疗效率低于 CT 引导。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d1dd/11431956/584f6b20212f/curroncol-31-00392-g001.jpg

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