Department of Diagnostic Radiology, School of Medicine, Keio University, Tokyo, Japan.
J Vasc Interv Radiol. 2013 Jun;24(6):813-21. doi: 10.1016/j.jvir.2012.12.026. Epub 2013 Feb 28.
To evaluate factors predicting local tumor progression after percutaneous cryoablation of lung tumors (PCLT).
Seventy-one consecutive patients with 210 tumors (11 primary and 199 metastatic pulmonary neoplasms; mean maximum diameter, 12.8 mm) were treated with 102 sessions of PCLT. Rates of local tumor progression and technique effectiveness were estimated by Kaplan-Meier method. Multiple variables were evaluated with the log-rank test, followed by uni- and multivariate multilevel analyses to identify independent risk factors, and hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated. All statistical tests were two-sided.
Median follow-up period was 454 days (range, 79-2,467 d). Local tumor progression occurred in 50 tumors (23.8%). One-, 2-, and 3-year local progression-free rates were 80.4%, 69.0%, and 67.7%, respectively, and technique effectiveness rates were 91.4%, 83.0%, and 83.0%, respectively. Existence of a thick vessel (diameter≥3 mm) no more than 3 mm from the edge of the tumor was assessed as an independent factor (HR, 3.84; 95% CI, 1.59-9.30; P = .003) associated with local progression by multivariate analysis.
Presence of a vessel at least 3 mm in diameter close to the tumor represents an independent risk factor for local progression after PCLT.
评估经皮冷冻消融治疗肺肿瘤(PCLT)后局部肿瘤进展的预测因素。
71 例 210 个肿瘤(11 个原发性和 199 个转移性肺肿瘤;最大直径平均为 12.8mm)的患者接受了 102 次 PCLT 治疗。采用 Kaplan-Meier 法估计局部肿瘤进展和技术有效性的发生率。采用对数秩检验对多个变量进行评估,然后进行单变量和多变量多层次分析,以确定独立的危险因素,并估计风险比(HRs)和 95%置信区间(CIs)。所有统计检验均为双侧检验。
中位随访时间为 454 天(范围,79-2467d)。50 个肿瘤(23.8%)发生局部肿瘤进展。1、2、3 年局部无进展生存率分别为 80.4%、69.0%和 67.7%,技术有效率分别为 91.4%、83.0%和 83.0%。肿瘤边缘 3mm 以内存在≥3mm 直径的厚血管被评估为独立的危险因素(HR,3.84;95%CI,1.59-9.30;P=0.003)。
肿瘤边缘至少 3mm 处存在大直径血管是 PCLT 后局部进展的独立危险因素。