State Key Laboratory of Oncology in South China and Department of Hepatobiliary Oncology, Sun Yat-Sen University Cancer Center, Guangzhou, China.
Clin Radiol. 2013 Jan;68(1):21-6. doi: 10.1016/j.crad.2012.05.007. Epub 2012 Jul 4.
To evaluate the efficacy and safety of percutaneous microwave ablation (MWA) in patients with larger hepatocellular carcinoma (HCC) tumours.
Eighty HCC patients with the maximum tumour measuring between 3 and 8 cm were treated using MWA. Of these patients, 57 had initial HCC, while 23 had recurrent HCC. Fifty-two patients had a main tumour measuring 3-5 cm, and 28 had a main tumour measuring 5-8 cm. Local tumour control, complications, long-term survival, and prognostic factors were analysed.
Complete ablation after the initial treatment was achieved in 70 of 80 (87.5%) patients. Sixteen of the 72 (22.2%) successfully treated patients developed local recurrence. Major complications occurred in 7.5% patients. No procedure-related mortality was observed. The 1, 2, 3, and 5 year overall survival rates after the initial ablation were 81.1, 68.2, 56.5, and 34.6%, with a median survival of 56 months. Univariate analysis revealed that small tumour size (p = 0.003) and pre-ablation α-foetoprotein (AFP) level ≤400 ng/ml (p = 0.042) were favourable prognostic factors of overall survival. Multivariate analysis identified only tumour size as the independent prognosis factor (p = 0.008).
Percutaneous MWA is effective and safe for treating larger HCC tumours. The local tumour control and long-term survival are acceptable.
评估经皮微波消融（MWA）治疗较大肝细胞癌（HCC）肿瘤的疗效和安全性。
对 80 例最大肿瘤直径为 3-8cm 的 HCC 患者进行 MWA 治疗。其中初发 HCC 57 例，复发性 HCC 23 例。主肿瘤直径 3-5cm 者 52 例，5-8cm 者 28 例。分析局部肿瘤控制、并发症、长期生存及预后因素。
80 例患者中，70 例（87.5%）初始治疗后完全消融。72 例成功治疗患者中有 16 例（22.2%）出现局部复发。7.5%的患者发生严重并发症。无与手术相关的死亡病例。初始消融后 1、2、3、5 年总生存率分别为 81.1%、68.2%、56.5%和 34.6%，中位生存时间为 56 个月。单因素分析显示，肿瘤体积小（p=0.003）和消融前α-胎蛋白（AFP）水平≤400ng/ml（p=0.042）是总生存的有利预后因素。多因素分析仅显示肿瘤大小是独立的预后因素（p=0.008）。
经皮 MWA 治疗较大 HCC 肿瘤是有效且安全的，局部肿瘤控制和长期生存是可接受的。
