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射频消融治疗肝肿瘤:消融边缘对局部肿瘤进展的影响。

Radiofrequency ablation of hepatic tumours: effect of post-ablation margin on local tumour progression.

机构信息

Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA.

出版信息

Eur Radiol. 2010 Apr;20(4):877-85. doi: 10.1007/s00330-009-1610-4. Epub 2009 Sep 16.

Abstract

PURPOSE

The purpose of this study was to retrospectively evaluate the relationship between post-ablation margins and local tumour progression following radiofrequency ablation (RFA) of hepatocellular carcinomas and colorectal liver metastases.

METHODS

Eighty-three patients with 107 hepatic tumours who underwent RFA were divided into two groups: the hepatocellular carcinoma (HCC) group (55 patients with 69 lesions) and the colorectal liver metastases group (28 patients with 38 lesions). Post-ablation margins were calculated on 1-month follow-up contrast-enhanced computed tomography (CT) or magnetic resonance imaging (MRI) studies. Efficacy was evaluated at 1-month post-ablation, then at 3-month intervals for the first year and biannually thereafter.

RESULTS

The results of the log-rank test showed that the minimum threshold post-ablation margin of 0.4 cm (P = 0.020) and tumour size smaller than 2.5 cm (P = 0.001) significantly correlated with local control for the HCC group. In the colorectal liver metastases group, the results of the log-rank test showed that the minimum threshold post-ablation margin of 0.4 cm (P = 0.345) and tumour size smaller than 2.5 cm (P = 0.168) did not correlate with local control.

CONCLUSION

Percutaneous RFA is more effective in achieving local control in patients with HCCs than with colorectal liver metastases.

摘要

目的

本研究旨在回顾性评估肝癌和结直肠癌肝转移射频消融(RFA)后消融边缘与局部肿瘤进展的关系。

方法

83 例 107 个肝脏肿瘤患者行 RFA 治疗,分为两组:肝细胞癌(HCC)组(55 例,69 个病灶)和结直肠癌肝转移组(28 例,38 个病灶)。在 1 个月的增强 CT 或 MRI 随访时计算消融边缘。在消融后 1 个月评估疗效,随后在第 1 年每 3 个月评估 1 次,此后每 6 个月评估 1 次。

结果

对数秩检验结果显示,HCC 组中,0.4cm 的最小消融边缘阈值(P=0.020)和肿瘤直径<2.5cm(P=0.001)与局部控制显著相关。在结直肠癌肝转移组中,0.4cm 的最小消融边缘阈值(P=0.345)和肿瘤直径<2.5cm(P=0.168)与局部控制无关。

结论

与结直肠癌肝转移相比,经皮 RFA 治疗 HCC 更能有效实现局部控制。

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