Background/Objectives: Cryoablation is a minimally invasive treatment option for patients with a small renal mass (SRM). We aimed to present the long-term functional and oncologic outcomes of cryoablation for SRMs. Methods: We retrospectively reviewed patients treated with percutaneous or laparoscopic cryoablation for an SRM (≤4 cm in diameter) at our tertiary hospital between October 2001 and December 2011. Primary outcomes included technical failure (persistent CT enhancement post-ablation) and progression (local recurrence or metastasis). Trifecta is defined as the absence of severe complications (Clavien–Dindo > 2), no oncological progression, and ≤10% decline in eGFR. Results: A total of 129 patients with a median age of 67 (IQR 58–74) years were analyzed. The median (IQR) clinical and radiologic follow-ups across all patients were 136 (54–180) and 74 (23–147) months, respectively, with a median (IQR) tumor volume of 3.3 (1.6–6.6) cm3. Among those with available biopsy data (n= 86), 62 (72%) were diagnosed with Renal Cell Carcinoma (RCC), and 24 (28%) exhibited benign pathologies, including angiomyolipoma, oncocytic neoplasm, and non-diagnostic pathology. Of all patients, six experienced high-grade complications. Among non-solitary kidney patients with available creatinine values between 13 and 36 months post-treatment, 64% had ≤10% eGFR decline compared to baseline. Notably, 58% (26/48) of patients with RCC (non-solitary kidney) achieved our trifecta definition at 36 months. Metastasis-free, cancer-specific, and overall survival at 15-year follow-up were 85%, 96%, and 46%, respectively. Univariable regression identified tumor volume and solitary kidney status at ablation as significant predictors for oncological progression. Conclusions: Cryoablation for the SRM showed sustained oncological and functional efficacy over long-term follow-up.
背景/目的：对于小肾肿瘤（SRM）患者，冷冻消融是一种微创治疗选择。本研究旨在展示冷冻消融治疗SRM的长期功能和肿瘤学结果。方法：我们回顾性分析了2001年10月至2011年12月期间在我院接受经皮或腹腔镜冷冻消融治疗的SRM（直径≤4厘米）患者。主要结局指标包括技术失败（消融后CT持续强化）和疾病进展（局部复发或转移）。"三重目标"定义为无严重并发症（Clavien–Dindo分级>2级）、无肿瘤学进展以及估算肾小球滤过率（eGFR）下降≤10%。结果：共分析了129例患者，中位年龄为67岁（四分位距[IQR] 58-74）。所有患者的中位临床随访时间和影像学随访时间分别为136个月（IQR 54-180）和74个月（IQR 23-147），中位肿瘤体积为3.3 cm³（IQR 1.6-6.6）。在有活检数据的患者（n=86）中，62例（72%）被诊断为肾细胞癌（RCC），24例（28%）显示为良性病理，包括血管平滑肌脂肪瘤、嗜酸细胞瘤和非诊断性病理。所有患者中，有6例发生了高级别并发症。在治疗后13至36个月内有可用肌酐值的非孤立肾患者中，64%的患者eGFR较基线下降≤10%。值得注意的是，58%（26/48）的RCC（非孤立肾）患者在36个月时达到了我们的"三重目标"定义。15年随访时，无转移生存率、癌症特异性生存率和总生存率分别为85%、96%和46%。单变量回归分析确定肿瘤体积和消融时是否为孤立肾是肿瘤学进展的显著预测因素。结论：长期随访显示，冷冻消融治疗SRM具有持续的肿瘤学和功能疗效。
肿瘤(癌症)患者之家