Kim Young Jun, Raman Steven S, Yu Nam C, Busuttil Ronald W, Tong Myron, Lu David S K
Department of Radiology, David Geffen School of Medicine at UCLA, 10833 Le Conte Ave., Los Angeles, CA 90095-1721, USA.
AJR Am J Roentgenol. 2008 Apr;190(4):1029-34. doi: 10.2214/AJR.07.2293.
Our purpose was to retrospectively evaluate percutaneous radiofrequency ablation of unifocal subcapsular hepatocellular carcinoma (HCC) in comparison with nonsubcapsular tumors with regard to the technical and clinical outcomes.
A total of 42 patients (23 men and 18 women; age range, 22-83 years) with unifocal HCC underwent percutaneous radiofrequency ablation as their sole interventional treatment between May 1998 and August 2003. Subcapsular tumors were selected for ablation if there was no large exophytic component, and they were ablated through an indirect puncture, a gradual increase in radiofrequency power output, and needle track ablation. Technical effectiveness after single-session radiofrequency ablation, complications, local tumor progression, overall survival, and event-free survival rates were compared between the two groups.
There were 15 patients with subcapsular HCC and 27 patients with nonsubcapsular HCC. The technical effectiveness was 93% (14/15) in the subcapsular HCC group and 96% (26/27) in the nonsubcapsular group (p > 0.99), complication rates were 0% (0/15) and 7.4% (2/27) (p = 0.53), and rates of local tumor progression were 21% (3/14) and 15% (4/26) (p = 0.68), respectively. No needle track or peritoneal seeding was found in either group. No significant differences were found in overall survival (3 years: 60% vs 56%; p = 0.78) and event-free survival rates (3 years: 59% vs 48%; p > 0.99) between the two groups.
Radiofrequency ablation of subcapsular HCC can be comparable to that of nonsubcapsular HCC with regard to the technical and clinical outcomes when there is proper patient selection and an optimized technique is used.
我们的目的是回顾性评估单灶性包膜下肝细胞癌（HCC）的经皮射频消融术与非包膜下肿瘤相比的技术和临床结果。
1998年5月至2003年8月期间，共有42例单灶性HCC患者（23例男性和18例女性；年龄范围22 - 83岁）接受了经皮射频消融作为其唯一的介入治疗。如果没有大的外生性成分，则选择包膜下肿瘤进行消融，并通过间接穿刺、逐渐增加射频功率输出和针道消融进行治疗。比较两组单次射频消融后的技术有效性、并发症、局部肿瘤进展、总生存率和无事件生存率。
有15例包膜下HCC患者和27例非包膜下HCC患者。包膜下HCC组的技术有效性为93%（14/15），非包膜下组为96%（26/27）（p > 0.99），并发症发生率分别为0%（0/15）和7.4%（2/27）（p = 0.53），局部肿瘤进展率分别为21%（3/14）和15%（4/26）（p = 0.68）。两组均未发现针道或腹膜种植转移。两组的总生存率（3年：60%对56%；p = 0.78）和无事件生存率（3年：59%对48%；p > 0.99）无显著差异。
当进行适当的患者选择并采用优化技术时，包膜下HCC的射频消融在技术和临床结果方面可与非包膜下HCC相媲美。
