Cryoablation for Endophytic Renal Cell Carcinoma: Intermediate-Term Oncologic Efficacy and Safety
박세홍, 박홍석, 김제종, 문두건, 강석호, 천준, 이정구, 고영휘, 강성구,
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박세홍 ( Park Se-Hong )
고려대학교 의과대학 비뇨기과학교실
박홍석 ( Park Hong-Seok )
고려대학교 의과대학 비뇨기과학교실
김제종 ( Kim Je-Jong )
고려대학교 의과대학 비뇨기과학교실
문두건 ( Moon Du-Geon )
고려대학교 의과대학 비뇨기과학교실
강석호 ( Kang Seok-Ho )
고려대학교 의과대학 비뇨기과학교실
천준 ( Cheon Jun )
고려대학교 의과대학 비뇨기과학교실
이정구 ( Lee Jeong-Gu )
고려대학교 의과대학 비뇨기과학교실
고영휘 ( Ko Young-Hwii )
고려대학교 의과대학 비뇨기과학교실
강성구 ( Kang Sung-Gu )
고려대학교 의과대학 비뇨기과학교실
KMID : 0358320100510080518
Abstract
Purpose: To evaluate the efficacy and safety of laparoscopic renal cryoablation (LRC) of small endophytic renal cell carcinoma, for which surgical treatment is technically difficult.
Materials and Methods: We enrolled patients with endophytic tumors from a prospectively collected database of 45 renal tumors in 39 patients who had undergone LRC from June 2005 to May 2009. An endophytic tumor was defined as less than 40% of the lesion extending off the surface of the kidney. We evaluated surgical and oncological outcomes.
Results: Among the treated tumors, 17 tumors (37.8%) were defined as endophytic tumors and 15 tumors from 14 patients were confirmed as renal cell carcinoma (RCC) in the pathologic examination of the tissue biopsy that was conducted at the time of LRC. The mean American Society of Anesthesiologists (ASA) score of the whole patient group was 2.9 (range, 1-4), and 85.7% (12/14) of the patients had an ASA physical status score over 3. The mean tumor size was 2.8 cm (range, 1.7-3.7 cm). The layout of the cryoprobe was carefully planned preoperatively on the basis of radiologic evaluation in all tumors. Multiple cryoprobes (mean, 3.2; range, 2-5) were used. No major complications, including open surgical conversion and nephrectomy due to bleeding, occurred. No patient experienced clinical symptoms of collecting system injuries. During the mean follow-up of 32.6 months (range, 12-51 months), radiologic evidence of tumor recurrence was found in one patient (6.7% for RCC). With the exception of this patient, all other patients have remained free of recurrence or metastasis, as determined by periodic radiologic workups.
Conclusions: In this series of patients with intermediate-term follow-up, LRC for endophytic renal cell carcinoma showed acceptable oncological and surgical outcomes without sequelae in the collecting system.
키워드
Cryosurgery;Kidney collecting tubules;Renal cell carcinoma;Ultrasonography
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