Percutaneous radio frequency ablation of renal masses: Results at a 2-year mean followup
Percutaneous radio frequency ablation of renal masses: Results at a 2-year mean followup
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DOI：
10.1097/01.ju.0000165655.91152.c5
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发表时间：
2005-08-01
影响因子：
6.6
通讯作者：
Solomon, SB
中科院分区：
文献类型：
--
作者：
Varkarakis, IM;Allaf, ME;Solomon, SB
目的：我们描述了我们的经验和结果，经皮计算机断层扫描引导射频消融（RFA）小（小于4 EM）肾肿瘤在2年的平均followup.Materials和方法：共49例（60肾肿瘤），平均年龄为63.9岁进行经皮射频消融。RFA的适应症是严重的合并症或既往腹部手术排除手术治疗，或易导致多发性肿瘤复发的遗传性疾病。首次随访成像的持续增强被认为是不完全治疗，所有此类患者均接受了活检，并接受了重复RFA。增强或扩大在随后的成像被认为是肿瘤复发，这些患者被告知进一步therapy.Results：3例（4肿瘤）被排除在评估由于死亡无关的原因或损失后续。平均随访27.5个月（范围12 - 48）时，共有46例患者（56个肿瘤）可用于评价。第一次RFA治疗6个肿瘤不完全，第二次治疗成功。46例患者中有3例在成功的初始治疗后复发。这些复发分别发生在RFA后24、25和31个月，并且都发生在中心肿瘤≥ 3.0 cm的患者中。94.6%的肿瘤（56例中的53例）实现了总体局部控制。结论：RFA是一种新兴的小型肾肿瘤替代治疗方式。较大（大于3.0 cm）的中央肿瘤代表了独特的技术挑战，使这些肿瘤更容易复发。需要长期随访以确定该技术的肿瘤耐久性。
Purpose: We describe our experience with and results of percutaneous computerized tomography guided radio frequency ablation (RFA) for small (less than 4 em) renal tumors at a 2-year mean followup.Materials and Methods: A total of 49 patients (60 renal tumors) with a mean age of 63.9 years underwent percutaneous RFA. Indications for RFA were severe comorbidities or previous abdominal surgery precluding operative management, or hereditary conditions predisposing to multiple tumor recurrence. Persistent enhancement on initial followup imaging was considered incomplete treatment and all such patients underwent biopsy and were offered repeat RFA. Enhancement or enlargement on subsequent imaging was considered tumor recurrence and these patients were counseled regarding further therapy.Results: Three patients (4 tumors) were excluded from evaluation due to death from unrelated causes or loss to followup. A total of 46 patients (56 tumors) were available for evaluation at a mean followup of 27.5 months (range 12 to 48). Six tumors were incompletely treated with the first RFA and successfully treated with a second session. Recurrences after successful initial treatment were seen in 3 of 46 patients. These recurrences developed 24, 25 and 31 months following RFA, respectively, and all occurred in patients with a central tumor of 3.0 cm or greater. Overall local control was achieved in 94.6% of tumors (53 of 56).Conclusions: RFA is an emerging alternative treatment modality for small renal tumors. Larger (greater than 3.0 cm) central tumors represent unique technical challenges, making these tumors more prone to recurrence. Long-term followup is needed to establish the oncological durability of this technique.