Background: Our purpose is to evaluate the long-term oncologic efficacy and survival rates of MRI-guided cryoablation for patients with biopsy-proven cT1a renal cell carcinoma (RCC). Materials and Methods: We retrospectively reviewed our renal ablation database between January 2007 and June 2021 and only included patients with solitary-biopsy-proven cT1a RCC (≤4 cm) who underwent MRI-guided cryoablation. We excluded patients with genetic syndromes, bilateral RCC, recurrent RCC or benign lesions, those without pathologically proven RCC lesions and patients who underwent radiofrequency ablation or CT-guided cryoablation. For each patient, we collected the following: age, sex, lesion size, right- or left-sided, pathology, ablation zone tumor recurrence, development of new tumor in the kidney other than ablation zone, development of metastatic disease, patient alive or not, date and cause of death. We used the Kaplan and Meier product limit estimator to estimate the survival outcomes. Results: Twenty-nine patients (median age 70 years) met our inclusion criteria. Twenty-nine MRI-guided cryoablation procedures were performed for twenty-nine tumor lesions with a median size of 2.2 cm. A Clavien–Dindo grade III complication developed in one patient (3.4%). Clear cell RCC was the most reported histology (n = 19). The median follow up was 4.5 years. No tumor recurrence or metastatic disease developed in any of the patients. Two patients developed new renal lesions separate from the ablation zone. The 5- and 10-year OS were 72% and 55.6%, respectively. The 5- and 10-year DFS were 90.5% and the 5-year and 10-year LRFS, MFS and CSS were all 100%. Conclusions: MRI-guided cryoablation is a safe treatment with a low complication rate. Long-term follow-up data revealed long-standing oncologic control.
背景：本研究旨在评估磁共振成像引导下冷冻消融术对经活检证实的cT1a期肾细胞癌患者的长期肿瘤学疗效及生存率。材料与方法：我们回顾性分析了2007年1月至2021年6月期间的肾脏消融数据库，仅纳入经单病灶活检证实为cT1a期（≤4厘米）肾细胞癌并接受磁共振成像引导下冷冻消融术的患者。排除标准包括：遗传综合征患者、双侧肾细胞癌患者、复发性肾细胞癌或良性病变患者、未经病理证实的肾细胞癌患者，以及接受射频消融或CT引导冷冻消融的患者。收集每位患者的以下信息：年龄、性别、病灶大小、左右侧位置、病理类型、消融区肿瘤复发情况、消融区外新发肾脏肿瘤情况、转移性疾病发生情况、患者生存状态、死亡日期及原因。采用Kaplan-Meier乘积限估计法评估生存结局。结果：共29例患者（中位年龄70岁）符合纳入标准。对29个肿瘤病灶（中位尺寸2.2厘米）实施了29次磁共振成像引导下冷冻消融术。1例患者（3.4%）出现Clavien-Dindo III级并发症。透明细胞肾细胞癌是最常见的组织学类型（n=19）。中位随访时间为4.5年。所有患者均未出现肿瘤复发或转移性疾病。2例患者在消融区外出现新发肾脏病灶。5年及10年总生存率分别为72%和55.6%，5年及10年无病生存率均为90.5%，5年及10年局部无复发生存率、无转移生存率及肿瘤特异性生存率均为100%。结论：磁共振成像引导下冷冻消融术是一种安全性高、并发症发生率低的治疗方式。长期随访数据显示该技术能实现持久的肿瘤控制。
肿瘤(癌症)患者之家