Over the recent years, progress in imaging techniques has led to an increased detection of kidney tumours, including small renal masses. While surgery is still the standard of care, there is a growing interest in minimally invasive methods. Ultrasound (US)-guided percutaneous ablation is particularly attractive because it is a safe and relatively simple procedure. In this study, we investigated the results of US-guided percutaneous radiofrequency ablation (RFA) and partial nephrectomy (PN) in the treatment of cT1a renal cancers. Between August 2016 and February 2022, 271 patients with renal tumours underwent percutaneous RFA as initial treatment in our institution. In the same period, 396 patients with renal tumours underwent surgical tumour excision. For the purpose of this study, only patients with confirmed renal cancer with matched age and tumour characteristics (size, location) were selected for both groups. Thus, a group of 44 PN patients and 41 RFA patients were formed with the same qualification criteria for both groups. Parameters such as procedure length, blood loss, hospital stay, analgesics used, and pre- and post-procedural serum creatinine were compared between these groups. Patients followed up with contrast-enhanced CT. There was no significant difference in age, tumour size, tumour location, and creatinine levels between these groups. All procedures were generally well tolerated. During a median follow-up of 28 months, two cases of recurrence/residual disease were found in each group. The overall survival was 100% in both groups, and all patients were disease-free at the end of observation. Percutaneous RFA was associated with a significantly shorter procedure length and hospital stay, lower blood loss, and lower analgesics used than PN. In the selected group of renal cancer patients, US-guided percutaneous RFA was associated with a shorter hospital stay, less analgesics used, and a shorter procedure length than PN, without differences in the oncological results or kidney function.
近年来，影像学技术的进步提高了肾脏肿瘤（包括小型肾肿块）的检出率。尽管手术仍是标准治疗方案，但人们对微创治疗方法的关注日益增加。超声引导下经皮消融术因其安全性和操作相对简便而备受青睐。本研究探讨了超声引导下经皮射频消融术与肾部分切除术治疗cT1a期肾癌的临床效果。2016年8月至2022年2月期间，我院共有271例肾肿瘤患者接受经皮射频消融术作为初始治疗，同期另有396例患者接受外科肿瘤切除术。为进行对照研究，我们筛选出年龄及肿瘤特征（大小、位置）相匹配、经病理确诊的肾癌患者，最终形成44例肾部分切除术患者与41例射频消融术患者的配对队列。两组患者在手术时长、术中失血量、住院时间、镇痛药物使用量以及术前术后血清肌酐水平等参数方面进行比较，并通过增强CT进行术后随访。结果显示，两组患者在年龄、肿瘤大小、肿瘤位置及肌酐水平方面均无显著差异。所有手术均耐受良好。在中位28个月的随访期间，两组各发现2例复发/残留病灶。两组患者总生存率均为100%，观察期结束时所有患者均无疾病进展。与肾部分切除术相比，经皮射频消融术具有手术时间更短、住院天数更少、术中失血量更低、镇痛药物使用量更少的显著优势。在经筛选的肾癌患者群体中，超声引导下经皮射频消融术在肿瘤学疗效及肾功能保护方面与肾部分切除术相当，但在缩短住院时间、减少镇痛药物使用及缩短手术时长方面更具优势。
肿瘤(癌症)患者之家