PDF(Pubmed)
Abstract：
Image-guided ablation (IGA) is a rapidly developing field in interventional oncology. There is some evidence suggesting IGA\'s non-inferiority compared with partial or radical nephrectomy for the treatment of small renal masses (SRM). However, these are mostly limited to retrospective cohort studies. This review article outlines the evidence comparing IGA to partial nephrectomy by collating the different survival measures and evaluates the challenges of producing clinical trials and high-quality evidence. The main challenges are due to the heterogeneity of SRM, patient selection bias, unstandardized endpoint and outcomes, and the lack of global practice standards. Despite the evidence thus far demonstrating that IGA stands as a non-inferior treatment modality for SRMs, exhibiting favorable short- and long-term outcomes, further robust research is needed to integrate ablation techniques into routine clinical practice with a multidisciplinary approach. There is emerging evidence that suggests randomized controlled trial in SRMs is possible, and technologies such as histotripsy as well as artificial intelligence are used in IGA.
摘要：
图像引导消融（IGA）是介入肿瘤学中发展迅速的领域。有证据表明，与部分或根治性肾切除术相比，IGA在治疗小肾肿块（SRM）方面具有非劣效性。然而,这些研究大多限于回顾性队列研究.这篇综述文章概述了通过比较不同的生存措施将IGA与肾部分切除术进行比较的证据，并评估了产生临床试验和高质量证据的挑战。主要挑战是由于SRM的异质性，患者选择偏见，非标准化终点和结果，缺乏全球实践标准。尽管迄今为止有证据表明IGA是SRM的非劣质治疗方式，表现出良好的短期和长期结果，需要进一步的强有力的研究,通过多学科方法将消融技术整合到常规临床实践中.有新的证据表明，SRM的随机对照试验是可能的，在IGA中使用了诸如组织学和人工智能之类的技术。
