Department of Medical Ultrasound, Tenth People's Hospital of Tongji University, Shanghai Tenth People's Hospital, Shanghai, China.
Br J Radiol. 2012 Aug;85(1016):1078-84. doi: 10.1259/bjr/24563774. Epub 2012 Feb 28.
The objective of this study was to evaluate the treatment efficacy and overall survival (OS) of percutaneous ultrasound-guided thermal ablation by means of microwave ablation or radiofrequency ablation for intrahepatic cholangiocarcinoma (ICC).
18 patients with 25 ICC nodules underwent ultrasound-guided thermal ablation with curative intention. 8 patients were primary cases and 10 were recurrent cases after curative resection. The local treatment response, complications and survivals were analysed.
Complete ablation was achieved in 23 (92.0%, 23/25) nodules (diameter, 0.7-4.3 cm; mean, 2.5 ± 0.9 cm) and incomplete ablation was found in 2 (8.0%, 2/25) larger tumours (6.4 and 6.9 cm in diameter). No death associated with the treatment was found. The major complication rate was 5.5% (1/18). The follow-up periods ranged from 1.3 to 86.2 months (mean, 20.5 ± 26.3 months; median, 8.7 months). OS rates for all patients at 6, 12, 36 and 60 months were 66.7%, 36.3%, 30.3% and 30.3%, respectively. By univariate analysis, the patient source (primary or recurrent case) was found to be a significant prognostic factor for OS rates (p=0.001). The patient source (p=0.001) and the number of nodules (p=0.038) were found to be significant prognostic factors for recurrence-free survival. OS rates for the primary ICC at 6, 12, 36 and 60 months were 87.5%, 75.0%, 62.5% and 62.5%, respectively.
Percutaneous ultrasound-guided thermal ablation is a safe and effective therapeutic technique for ICC. Acceptable survival can be achieved in primary ICCs, whereas the prognosis of recurrent ICCs is relatively poor.
本研究旨在评估经皮超声引导下微波或射频消融热消融治疗肝内胆管癌（ICC）的疗效和总生存期（OS）。
18 例 25 个 ICC 结节患者接受了有治愈意图的超声引导下热消融治疗。8 例为初发病例，10 例为根治性切除后复发。分析局部治疗反应、并发症和生存率。
23 个（92.0%，23/25）结节（直径 0.7-4.3cm；平均 2.5±0.9cm）完全消融，2 个较大肿瘤（直径 6.4 和 6.9cm）不完全消融（8.0%，2/25）。无与治疗相关的死亡。主要并发症发生率为 5.5%（1/18）。随访时间为 1.3-86.2 个月（平均 20.5±26.3 个月；中位数 8.7 个月）。所有患者的 6、12、36 和 60 个月 OS 率分别为 66.7%、36.3%、30.3%和 30.3%。单因素分析发现，患者来源（初发或复发）是 OS 率的显著预后因素（p=0.001）。患者来源（p=0.001）和结节数（p=0.038）是无复发生存的显著预后因素。初发 ICC 的 6、12、36 和 60 个月 OS 率分别为 87.5%、75.0%、62.5%和 62.5%。
经皮超声引导下热消融是治疗 ICC 的一种安全有效的治疗技术。初发 ICC 可获得可接受的生存，而复发 ICC 的预后则相对较差。
