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Wenhui Zhou Ronald S. Arellano 《Journal of vascular and interventional radiology : JVIR》2018,29(7):943-951
Purpose
To evaluate perioperative outcomes of thermal ablation with microwave (MW), radiofrequency (RF), and cryoablation for stage T1c renal cell carcinoma (RCC).Materials and Methods
A retrospective analysis of 384 patients (mean age, 71 y; range, 22–88 y) was performed between October 2006 and October 2016. Mean radius, exophytic/endophytic, nearness to collecting system or sinus, anterior/posterior, and location relative to polar lines; preoperative aspects and dimensions used for anatomic classification; and centrality index scores were 6.3, 7.9, and 2.7, respectively. Assessment of pre- and postablation serum blood urea nitrogen, creatinine, and estimated glomerular filtration rate was performed to assess functional outcomes. Linear regression analyses were performed to compare sedation medication dosages among the three treatment cohorts. Univariable and multivariable logistic regression analyses were performed to compare rates of residual disease and complications among treatment modalities.Results
A total of 437 clinical stage T1N0M0 biopsy-proven RCCs measuring 1.2–6.9 cm were treated with computed tomography (CT)–guided MW ablation (n = 44; 10%), RF ablation (n = 347; 79%), or cryoablation (n = 46; 11%). There were no significant differences in patient demographic or tumor characteristics among cohorts. Complication rates and immediate renal function changes were similar among the three ablation modalities (P = .46 and P = .08, respectively). MW ablation was associated with significantly decreased ablation time (P < .05), procedural time (P < .05), and dosage of sedative medication (P < .05) compared with RF ablation and cryoablation.Conclusions
CT-guided percutaneous MW ablation is comparable to RF ablation or cryoablation for the treatment of stage T1N0M0 RCC with regard to treatment response and is associated with shorter treatment times and less sedation than RF ablation or cryoablation. In addition, the safety profile of CT-guided MW ablation is noninferior to those of RF ablation or cryoablation. 相似文献3.
PADUA and R.E.N.A.L. nephrometry scores correlate with perioperative outcomes of robot‐assisted partial nephrectomy: analysis of the Vattikuti Global Quality Initiative in Robotic Urologic Surgery (GQI‐RUS) database 
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Outcomes of high‐complexity renal tumours with a Preoperative Aspects and Dimensions Used for an Anatomical (PADUA) score of ≥10 after robot‐assisted partial nephrectomy with a median 46.5‐month follow‐up: a tertiary centre experience 下载免费PDF全文
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目的:探讨PADUA评分系统在保留肾单位手术(NSS)中与手术时间、热缺血时间、并发症等相关因素的关系。方法:回顾性分析127例次行NSS的124例肾肿瘤患者的临床资料,行PADUA评分,并利用χ2检验、Fisher确切检验等分析PADUA评分与手术时间、热缺血时间、并发症、出血量、术后住院时间、术后第1天血肌酐变化率的关系。结果:PADUA评分低、中、高度复杂肿瘤分别为40例、62例、25例,LNSS组手术时间与PADUA评分有关(P=0.012),ONSS组只有高度与低度复杂肿瘤之间有统计学意义(P=0.005)。对于低度复杂肿瘤,LNSS比ONSS手术时间短(P=0.009)。PADUA评分与热缺血时间相关,与围手术期并发症、术后第1天血肌酐变化率无关。ONSS组出血量与PADUA评分无关,而LNSS组两者有关(P=0.031)。LNSS组高度比低度复杂肿瘤术后住院时间长。结论:PADUA评分与NSS手术时间、热缺血时间等相关因素密切相关,可以预测手术相关结果,指导肾肿瘤的治疗。 相似文献
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目的 探讨R.E.N.A.L.,PADUA和C-index三种评分系统在肾部分切除术中的应用价值.方法 对本院2013年1月至2020年6月收治的134例行PN的单侧肾肿瘤患者临床资料进行回顾性分析,阅读134例单侧肾肿瘤患者术前影像学资料,应用R.E.N.AL.,PADUA和C-index三种评分系统对肾肿瘤解剖特征... 相似文献
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《Urologic oncology》2015,33(4):167.e1-167.e6
ObjectiveTo investigate whether a combination of variables from each nephrometry system improves performance. There are 3 first-generation systems that quantify tumor complexity: R.E.N.A.L. nephrometry score (RNS), preoperative aspects and dimensions used for an anatomical (PADUA) classification (PC), and centrality index (CI). Although each has been subjected to validation and comparative analysis, to our knowledge, no work has been done to combine variables from each method to optimize their performance.Patients and methodsScores were assigned to each of 276 patients undergoing partial nephrectomy (PN) or radical nephrectomy (RN). Individual components of all 3 systems were evaluated in multivariable logistic regression analysis of surgery type (PN vs. RN) and combined into a “second-generation model.”ResultsIn multivariable analysis, each scoring system was a significant predictor of PN vs. RN (P<0.0001). Of the first-generation systems, CI was most highly correlated with surgery type (area under the curve [AUC] = 0.91), followed by RNS (AUC = 0.90) and PC (AUC = 0.88). Each individual component of these scoring systems was also a predictor of surgery type (P<0.0001). In a multivariable model incorporating each component individually, 4 were independent predictors of surgery type (each P<0.005): tumor size (RNS and PC), nearness to the collecting system (RNS), location along the lateral rim (PC), and centrality (CI). A novel model in which these 4 variables were rescaled outperformed each first-generation system (AUC = 0.91).ConclusionsOptimization of first-generation models of renal tumor complexity results in a novel scoring system, which strongly predicts surgery type. This second-generation model should aid comprehension, but future work is still needed to establish the most clinically useful model. 相似文献
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Are there limits of robotic partial nephrectomy? TRIFECTA outcomes of open and robotic partial nephrectomy for completely endophytic renal tumors 下载免费PDF全文
下载免费PDF全文 Nina N. Harke MD Philipp Mandel MD Jorn H. Witt MD Christian Wagner MD Andrej Panic MD Anselm Boy MD Alexander Roosen MD Burkhard Ubrig MD Andreas Schneller MD Frank Schiefelbein MD Nina Wagener MD Patrick Honeck MD Georg Schoen MD Boris Hadaschik MD Maurice S. Michel MD Maximilian C. Kriegmair MD 《Journal of surgical oncology》2018,118(1):206-211
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Ye Zhang Yanchao Qu Lili Jiao Weiping Zhang Ning Sun Jun Tian Minglei Li Hongcheng Song 《Journal of pediatric surgery》2018,53(7):1326-1329