经皮热消融治疗肾转移小肿瘤。

Chisami Nagata, Masashi Fujimori, Takashi Yamanaka, Yuichi Sugino, Naritaka Matsushita, Seiya Kishi, Hikari Fukui, Yuki Omori, Kohei Nishikawa, Hajime Sakuma
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摘要

目的:回顾性评价热消融治疗肾转移性肿瘤的疗效。材料和方法:本研究纳入2009 - 2020年间连续13例接受热消融治疗的肾转移性小肿瘤(≤3cm)患者。8例患者在肾消融术中出现肾外肿瘤。原发肿瘤为腺样囊性癌4例,肺癌3例,血管外皮细胞瘤3例,平滑肌肉瘤2例,甲状腺癌1例。评估治疗效果、安全性、生存率、预后因素及肾功能。结果:我们进行了18次消融(冷冻消融,n = 13;射频消融术(n = 5)治疗19例平均直径为1.7 cm的肾转移瘤,主要技术有效率为100%,无手术相关死亡或主要并发症。消融后6个月肾功能明显下降(P = 0.0039)。在平均31.2±22.4个月(范围2.7-71.4个月)的随访期间,1例患者在射频消融后11.9个月局部肿瘤进展。消融后1年和3年的总生存率分别为76.9%(95%可信区间[CI], 54.0%-99.8%)和59.3% (95% CI, 31.3%-87.3%)。单因素分析中,肿瘤大小≥2 cm (P = 0.02)和非小细胞肺癌转移(P = 0.001)是影响预后的显著因素,多因素分析中,非小细胞肺癌转移(P = 0.01)是影响预后的显著因素。结论:经皮热消融治疗小肾转移瘤安全可行,能有效控制局部肿瘤。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

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Percutaneous Thermal Ablation for Managing Small Renal Metastatic Tumors.

Purpose: To retrospectively evaluate the treatment outcomes of thermal ablation for renal metastatic tumors.

Materials and methods: Thirteen consecutive patients with small renal metastatic tumors (≤3 cm), who underwent thermal ablation between 2009 and 2020, were included in this study. Eight patients had extra-renal tumors during renal ablation. The primary tumors were adenoid cystic carcinoma in four patients, lung cancer in three, hemangiopericytoma in three, leiomyosarcoma in two, and thyroid cancer in one. The therapeutic effects, safety, survival rate, prognostic factor, and renal function were evaluated.

Results: We performed 18 ablation sessions (cryoablation, n = 13; radiofrequency ablation, n = 5) on 19 renal metastases with a mean diameter of 1.7 cm, which resulted in a primary technique efficacy rate of 100% without procedure-related deaths or major complications. Renal function significantly declined 6 months after ablation (P = 0.0039). During the mean follow-up period of 31.2 ± 22.4 months (range, 2.7-71.4 months), one patient had local tumor progression at 11.9 months following radiofrequency ablation. The overall survival rates at 1 and 3 years after ablation were 76.9% (95% confidence interval [CI], 54.0%-99.8%) and 59.3% (95% CI, 31.3%-87.3%), respectively. Tumor size ≥ 2 cm (P = 0.02) and metastasis from non-small cell lung cancer (P = 0.001) were significant worse prognostic factors in univariate analysis, and metastasis from non-small cell lung cancer (P = 0.01) was significant in multivariate analysis.

Conclusions: Percutaneous thermal ablation for small renal metastases is safe and feasible and can control local tumors.

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