Kim John, Uy Michael, Cheng Alan, Syed Lamisa, Almuaiqel Muaiqel, Matsumoto Edward, Kapoor Anil, Bansal Rahul
Division of Urology, Department of Surgery, McMaster University, Hamilton, Canada.
Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Canada.
J Endourol. 2025 Jun;39(6):594-600. doi: 10.1089/end.2024.0849. Epub 2025 Apr 24.
We aimed to assess long-term outcomes of radiofrequency ablation (RFA) for biopsy-proven renal cell carcinoma (RCC), with a minimum follow-up of 10 years. We retrospectively identified patients who underwent RFA for renal masses at our center between 2004 and 2014. All patients who underwent RFA for a single, unilateral renal mass measuring ≤4 cm and had a minimum follow-up of 10 years were included. Our primary outcome was RCC recurrence. Kaplan-Meier curves were used to identify recurrence-free, metastasis-free, cancer-specific, and overall survival rates. Multivariate binary logistic regression was used to determine predictors of recurrence. A total of 75 patients were included in our study. Median follow-up was 131 months (interquartile range [IQR], 109-151 months). Median tumor size was 2.7 cm (IQR, 2.1-3.3 cm), and the median RENAL nephrometry score was 7 (IQR, 5-8). A total of 70.7% of pathology results showed clear cell RCC. Nine patients experienced RCC recurrence with a median time to recurrence of 54.4 months (IQR, 17.3-70.3 months). Two patients died due to metastatic RCC, and median time to death was 97.5 months (IQR, 55.8-128 months). Overall recurrence-free survival was 88%, and cancer-specific survival was 97%. No patients developed recurrence after 10 years. Univariate and multivariate regression did not identify any predictors of recurrence. RFA is a safe and effective treatment option for T1a RCC. Rates of recurrence and cancer-specific mortality are low at 10 years postprocedure. No patient or tumor factors were identified as predictors for RCC recurrence.
我们旨在评估经活检证实的肾细胞癌（RCC）患者接受射频消融（RFA）治疗的长期疗效，随访时间至少为10年。我们回顾性地确定了2004年至2014年间在本中心接受肾肿块RFA治疗的患者。纳入所有接受RFA治疗单个、单侧肾肿块且肿块直径≤4 cm并至少随访10年的患者。我们的主要结局是RCC复发。采用Kaplan-Meier曲线确定无复发生存率、无转移生存率、癌症特异性生存率和总生存率。采用多变量二元逻辑回归确定复发的预测因素。我们的研究共纳入75例患者。中位随访时间为131个月（四分位间距[IQR]，109 - 151个月）。中位肿瘤大小为2.7 cm（IQR，2.1 - 3.3 cm），中位RENAL肾计量评分7分（IQR，5 - 8）。70.7%的病理结果显示为透明细胞RCC。9例患者出现RCC复发，复发中位时间为54.4个月（IQR，17.3 - 70.3个月）。2例患者死于转移性RCC，死亡中位时间为97.5个月（IQR，55.8 - 128个月）。总体无复发生存率为88%，癌症特异性生存率为97%。10年后无患者出现复发。单变量和多变量回归均未发现任何复发预测因素。RFA是T1a期RCC的一种安全有效的治疗选择。术后10年复发率和癌症特异性死亡率较低。未发现患者或肿瘤因素可作为RCC复发的预测因素。
