Long-Term Oncologic Outcomes After Radiofrequency Ablation for T1 Renal Cell Carcinoma

摘要: Abstract Background Radiofrequency ablation (RFA) of renal cell carcinoma (RCC) is used to obtain local control small masses. However, available long-term oncologic outcomes for RFA RCC are limited by numbers, short follow-up, and lack pathologic diagnoses. Objective To assess the effectiveness treatment biopsy-proven RCC. Design, setting, participants Exclusion criteria included prior or metastatic RCC, familial syndromes, T2 We retrospectively reviewed 185 patients with sporadic T1 Median follow-up was 6.43 yr (interquartile range [IQR]: 5.3–7.7). Outcome measurements statistical analysis The chi-square test Wilcoxon rank-sum tests were compare proportions medians, respectively. Disease-specific survival overall (OS) calculated using Kaplan-Meier analysis, then stratified tumor stage, comparisons made log-rank analysis. 5-yr disease-free (DFS) OS rates reported. A p value Results limitations size 3cm (IQR: 2.1−3.9cm). Tumor stage T1a: 143 (77.3%) T1b: 42 (22.7%). Twenty-four (13%) retreated residual disease. There 12 recurrences (6.5%), 6 in T1a disease (4.2%) T1b (14.3%) ( =0.0196). time recurrence 2.5 yr. Local salvage performed six patients, whom five remain free at 3.8-yr median follow-up. only significant predictor DFS on multivariate At last 164 (88.6%) (T1a: n =132 [92.3%]; =32 [76.2%]; =0.0038). similar regardless =0.06). Five developed metachronous tumors (2.7%). Four extrarenal metastases (2.2%), three died (1.6%). Conclusions In poor surgical candidates, results durable low risk Higher correlates a decreased survival. Long-term surveillance necessary following RFA. Patient selection based characteristics, comorbid disease, life expectancy paramount importance.