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T1a期肾癌冷冻消融术——波兰的首次经验

T1a renal cancer cryoablation - first experiences in Poland.

作者信息

Rosiak Grzegorz, Franke Jakub, Konecki Dariusz, Milczarek Krzysztof, Ostrowski Tomasz, Nowakowski Robert, Demkow Tomasz, Gałązka Zbigniew

机构信息

2 Department of Radiology, Medical University of Warsaw, Warsaw, Poland.

Department of General, Vascular, Endocrine, and Transplant Surgery, Medical University of Warsaw, Warsaw, Poland.

出版信息

Pol J Radiol. 2024 Sep 23;89:e453-e456. doi: 10.5114/pjr/191839. eCollection 2024.

Abstract

PURPOSE

Cryoablation is one of the methods of treating patients with renal cancer with curative intent. This procedure is not widely available in Poland due to the lack of reimbursement until April 2023. The purpose of this study is to present the results of the first experiences in cryoablation of renal cell carcinoma in Poland.

MATERIAL AND METHODS

Patients with renal cell carcinoma in T1a stage (up to 4 cm in diameter) were treated with percutaneous cryoablation between December 2020 and December 2023. All patients were disqualified from surgical treatment due to age, comorbidities, or history of nephrectomy. Diagnosis was confirmed by computed tomography (CT)-guided core needle biopsy that was performed 2-4 weeks before cryoablation.

RESULTS

Twenty-five patients underwent CT-guided cryoablation of T1a renal cancer. The mean age of the patients was 77 years (43-91 years). The mean diameter of lesions was 27 mm (15-40 mm). None of the patients presented with local or distant recurrence within the mean 12-months of follow-up period (100% progression-free survival). Urine leak treated with a stent was detected in one patient. Four patients died within the follow-up period, but none of the deaths was directly related to the procedure.

CONCLUSIONS

Cryoablation is an effective and safe procedure and should be available to more patients in Poland.

摘要

目的

冷冻消融是一种旨在治愈肾癌患者的治疗方法。由于直到2023年4月都没有报销,该手术在波兰尚未广泛应用。本研究的目的是介绍波兰首例肾细胞癌冷冻消融的经验结果。

材料与方法

2020年12月至2023年12月期间,对T1a期(直径达4厘米)的肾细胞癌患者进行了经皮冷冻消融治疗。所有患者因年龄、合并症或肾切除术史而不适合手术治疗。在冷冻消融前2 - 4周通过计算机断层扫描(CT)引导下的粗针活检确诊。

结果

25例患者接受了CT引导下的T1a期肾癌冷冻消融治疗。患者的平均年龄为77岁(43 - 91岁)。病变的平均直径为27毫米(15 - 40毫米)。在平均12个月的随访期内,没有患者出现局部或远处复发(无进展生存率为100%)。1例患者检测到用支架治疗的尿漏。4例患者在随访期内死亡,但无一例死亡与手术直接相关。

结论

冷冻消融是一种有效且安全的手术,在波兰应该可供更多患者使用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ccea/11497588/2be20b437480/PJR-89-191839-g001.jpg

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