Department of Interventional Ultrasound, Chinese PLA General Hospital, 28 Fuxing Road, Beijing 100853, China.
Eur J Radiol. 2012 Oct;81(10):2495-9. doi: 10.1016/j.ejrad.2011.10.019. Epub 2011 Dec 1.
To determine the incidence and risk factors associated with needle tract seeding after percutaneous microwave ablation (MWA) of liver cancer under ultrasound guidance.
Over a 14-year period, a total of 1462 patients with 2530 malignant nodules were treated by MWA. The influence of age, sex, Child-pugh classification, tumor size, tumor position, previous biopsy, insertion number and antenna type on the risk of neoplastic seeding was assessed. The survival of seeding patients after the MWA was analyzed.
Eleven patients with 12 nodules (0.47% per tumor, 0.75% per patient) were identified with needle tract seeding with an interval time of 6-37 (median 10) months after MWA. The mean size of the seeding nodule was 2.3 ± 0.7 cm (from 1.3 to 3.9 cm). Only previous biopsy was significantly associated with neoplastic seeding (P=0.02). All the seeding lesions were successfully treated by resection, MWA, radiation or high intensity focus ultrasound. The median survival period of the 11 patients after the MWA was 36.0 months. The cumulative survival rates of the 11 patients after the MWA at 1-, 2-, 3-, 4- and 5-year were 90.9%, 72.7%, 62.3%, 31.2% and 15.6%, respectively.
The results showed that the neoplastic seeding was a low risk complication of percutaneous MWA of liver cancer and was considered acceptable in general.
确定超声引导下经皮微波消融(MWA)治疗肝癌后针道种植的发生率及相关危险因素。
在 14 年期间,共有 1462 例 2530 个恶性结节接受了 MWA 治疗。评估了年龄、性别、Child-Pugh 分级、肿瘤大小、肿瘤位置、既往活检、插入次数和天线类型对肿瘤种植风险的影响。分析了 MWA 后种植患者的生存情况。
11 例 12 个结节(0.47%/个肿瘤,0.75%/例患者)在 MWA 后 6-37 个月(中位 10 个月)时发现针道种植。种植结节的平均直径为 2.3±0.7cm(1.3-3.9cm)。只有既往活检与肿瘤种植显著相关(P=0.02)。所有种植病变均通过切除、MWA、放疗或高强度聚焦超声成功治疗。11 例患者在 MWA 后的中位生存时间为 36.0 个月。11 例患者在 MWA 后 1、2、3、4 和 5 年的累积生存率分别为 90.9%、72.7%、62.3%、31.2%和 15.6%。
结果表明,肿瘤种植是经皮 MWA 治疗肝癌的一种低风险并发症,总体上可以接受。