Department of Radiology, Chonnam National University Medical School and Chonnam National University Hwasun Hospital, Hwasun 519-809, Korea.
Korean J Radiol. 2012 Jan-Feb;13 Suppl 1(Suppl 1):S104-11. doi: 10.3348/kjr.2012.13.S1.S104. Epub 2012 Apr 23.
To evaluate the effectiveness of ultrasound-guided radiofrequency (RF) ablation in patients with incompletely treated hepatocellular carcinoma (HCC) after transcatheter arterial chemoembolization (TACE) and to evaluate possible prognostic factors for this therapy.
Thirty nine patients with incompletely treated single HCC (≤ 5 cm) after TACE were treated with RF ablation. All patients were evaluated for complete tumor ablation rate, local recurrence-free rate, overall survival rate, and complications. Local recurrence-free rate and overall survival rate were calculated using the Kaplan-Meier method. The possible prognostic factors of local recurrence-free rate and survival rate were analyzed using Cox proportional-hazards regression model.
The complete tumor ablation rate was 92.3%. Local recurrence-free rates for 1-, 2-, 3-, and 5-years were 81.7%, 63.1%, 53.6%, and 35.7%, respectively. One-, 2-, 3-, and 5-year overall survival rates were 96.9%, 82.9%, 67.8%, and 48.4%, respectively. Among prognostic factors included in the analysis, only tumor diameter (≤ 2 cm versus > 2 cm) was statistically significant in terms of predicting local recurrence. Complications were observed in two patients, one with liver abscess and the other with portal venous thrombosis.
Ultrasound-guided RF ablation could be effective and safe in treating incompletely treated HCC after TACE. The diameter of HCC was a significant prognostic factor for local recurrence.
评估超声引导下射频（RF）消融治疗经导管动脉化疗栓塞（TACE）后未完全治疗的肝细胞癌（HCC）的疗效，并评估该治疗的可能预后因素。
39 例 TACE 后未完全治疗的单发 HCC（≤5cm）患者接受 RF 消融治疗。所有患者均评估完全肿瘤消融率、局部无复发生存率、总生存率和并发症。采用 Kaplan-Meier 法计算局部无复发生存率和总生存率。采用Cox 比例风险回归模型分析局部无复发生存率和生存率的可能预后因素。
完全肿瘤消融率为 92.3%。1、2、3、5 年的局部无复发生存率分别为 81.7%、63.1%、53.6%和 35.7%。1、2、3、5 年总生存率分别为 96.9%、82.9%、67.8%和 48.4%。在纳入分析的预后因素中，只有肿瘤直径（≤2cm 与>2cm）在预测局部复发方面具有统计学意义。两名患者出现并发症，其中 1 例为肝脓肿，另 1 例为门静脉血栓形成。
超声引导下 RF 消融治疗 TACE 后未完全治疗的 HCC 是有效且安全的。HCC 的直径是局部复发的一个重要预后因素。
