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肺肿瘤经皮射频消融术后局部进展的危险因素:基于对342例肿瘤的初步回顾评估

Risk factors for local progression after percutaneous radiofrequency ablation of lung tumors: evaluation based on a preliminary review of 342 tumors.

作者信息

Hiraki Takao, Sakurai Jun, Tsuda Toshihide, Gobara Hideo, Sano Yoshifumi, Mukai Takashi, Hase Soichiro, Iguchi Toshihiro, Fujiwara Hiroyasu, Date Hiroshi, Kanazawa Susumu

机构信息

Department of Radiology, Okayama University Medical School, Okayama, Japan.

出版信息

Cancer. 2006 Dec 15;107(12):2873-80. doi: 10.1002/cncr.22333.

Abstract

BACKGROUND

The purpose of the study was to retrospectively evaluate the risk factors for local progression after percutaneous radiofrequency (RF) ablation of lung tumors.

METHODS

The study included 128 patients (77 men, 51 women; mean age, 61.3 years) with 342 tumors (25 primary and 317 metastatic lung neoplasms; mean long-axis diameter, 1.7 cm) treated with RF ablation. The overall primary and secondary technique effectiveness rates were estimated using Kaplan-Meier analysis. Multiple variables were analyzed using the log-rank test, followed by multivariate multilevel analysis to determine independent risk factors for local progression. The primary and secondary technique effectiveness rates were again estimated when considering only tumors without independent risk factors.

RESULTS

The median follow-up period was 12 months (range, 6-47 months). The overall primary and secondary technique effectiveness rates were 72% and 84% at 1 year, 60% and 71% at 2 years, and 58% and 66% at 3 years, respectively. Larger tumor size (hazard ratio [HR], 1.97; 95% confidence interval [95% CI], 1.47-2.65; P < .00001) and the use of an internally cooled electrode (HR, 2.32; 95% CI, 1.10-4.90; P = .027) were assessed as independent risk factors for local progression. The primary and secondary technique effectiveness rates when considering tumors smaller than 2 cm and treated with a multitined expandable electrode were 89% and 89% at 1 year and 66% and 78% at 2 years, respectively.

CONCLUSIONS

Larger tumor size and the use of an internally cooled electrode were independent risk factors for local progression after RF ablation of lung tumors.

摘要

背景

本研究旨在回顾性评估经皮射频(RF)消融肺肿瘤后局部进展的危险因素。

方法

本研究纳入了128例患者(77例男性,51例女性;平均年龄61.3岁),共342个肿瘤(25个原发性和317个转移性肺肿瘤;平均长轴直径1.7 cm)接受了RF消融治疗。采用Kaplan-Meier分析估计总体原发性和继发性技术有效率。使用对数秩检验分析多个变量,随后进行多变量多层次分析以确定局部进展的独立危险因素。仅考虑无独立危险因素的肿瘤时,再次估计原发性和继发性技术有效率。

结果

中位随访期为12个月(范围6 - 47个月)。总体原发性和继发性技术有效率在1年时分别为72%和84%,2年时分别为60%和71%,3年时分别为58%和66%。较大的肿瘤大小(风险比[HR],1.97;95%置信区间[95%CI],1.47 - 2.65;P <.00001)和使用内部冷却电极(HR,2.32;95%CI,1.10 - 4.90;P =.027)被评估为局部进展的独立危险因素。考虑小于2 cm且使用多尖可扩张电极治疗的肿瘤时,原发性和继发性技术有效率在1年时分别为89%和89%,2年时分别为66%和78%。

结论

较大的肿瘤大小和使用内部冷却电极是肺肿瘤RF消融后局部进展的独立危险因素。

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