Purpose

To retrospectively evaluate the clinical outcomes of percutaneous ultrasound (US)-guided radiofrequency ablation (RFA) in treatment of adrenal metastasis (AM), and to compare with adrenalectomy (Adx).

Methods

From June 2008 to August 2018, a total of 60 patients with AM treated at our hospital were retrospectively reviewed, of whom 29 treated by RFA (RFA group) and 31 by Adx (Adx group). The technical success, local tumor progression (LTP) and overall survival (OS) after the treatment were evaluated and compared.

Results

In RFA group, the first technical success was 72.4% and the second technical success was 86.2%. In Adx group, all the AMs were successfully resected. After 24.5 ± 19.1 months follow-up period, a total of 8 patients (6 in RFA group and 2 in Adx group) were detected LTP. The 1-, 2- and 3- LTP rates after treatment were 17.1%, 30.9% and 44.7% in RFA group, and 6.5%, 6.5% and 6.5% in Adx group, respectively (P = 0.028). However, for AM ≤ 5 cm, the LTP between the two groups were comparable (P = 0.068). The 1-, 2- and 3- OS rates after treatment for AM were 85.0%, 42.4% and 27.8% in RFA group, and 93.0%, 66.1% and 52.3% in Adx group, respectively (P = 0.057). RFA offered shorter treatment time (23.6 ± 16.9 vs. 155.6 ± 58.8 min, P < 0.001), shorter hospital stay (7.8 ± 3.9 vs. 15.0 ± 4.9 days, P < 0.001), and lower hospital cost ($3405.7 ± 1067.8 vs. $5248.0 ± 2261.3, P = 0.003) than Adx.

Conclusion

In comparison with Adx, percutaneous US-guided RFA, as an alternative treatment, is feasible and effective in controlling AM, especially in AM ≤ 5 cm in diameter.

中文翻译：

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经皮射频消融与肾上腺切除术治疗肾上腺转移的疗效：一项回顾性比较研究。

目的

回顾性评估经皮超声（US）引导的射频消融（RFA）治疗肾上腺转移瘤（AM）的临床效果，并与肾上腺切除术（Adx）进行比较。

方法

从2008年6月至2018年8月，对我院收治的60例AM患者进行回顾性回顾，其中RFA组（RFA组）29例，Adx组（Adx组）31例。评估并比较治疗后的技术成功率，局部肿瘤进展（LTP）和总体生存率（OS）。

结果

在RFA组中，第一次技术成功率为72.4％，第二次技术成功率为86.2％。在Adx组中，所有AM均已成功切除。在24.5±19.1个月的随访期后，总共检测出8例患者（RFA组6例，Adx组2例）。RFA组治疗后的1、2和3-LTP发生率分别为17.1％，30.9％和44.7％，Adx组分别为6.5％，6.5％和6.5％（P  = 0.028）。但是，对于AM≤5 cm，两组之间的LTP相当（P  = 0.068）。RFA组接受AM治疗后的1、2和3-OS率分别为85.0％，42.4％和27.8％，Adx组分别为93.0％，66.1％和52.3％（P  = 0.057）。RFA缩短了治疗时间（23.6±16.9分钟与155.6±58.8分钟，P <0.001），住院时间更短（7.8±3.9与15.0±4.9天，P  <0.001）和较低的住院成本（3405.7±1067.8与5248.0±2261.3，P  = 0.003）。

结论

与Adx相比，经皮US引导的RFA作为替代治疗在控制AM中是可行且有效的，尤其是在直径≤5 cm的AM中。