Ihara Hiroki, Gobara Hideo, Hiraki Takao, Mitsuhashi Toshiharu, Iguchi Toshihiro, Fujiwara Hiroyasu, Matsui Yusuke, Soh Junichi, Toyooka Shinichi, Kanazawa Susumu
Department of Radiology, Okayama University Medical School, 2-5-1 Shikata-cho kita-ku, Okayama 700-8558, Japan.
Department of Radiology, Okayama University Medical School, 2-5-1 Shikata-cho kita-ku, Okayama 700-8558, Japan.
J Vasc Interv Radiol. 2016 Jan;27(1):87-95. doi: 10.1016/j.jvir.2015.07.025. Epub 2015 Aug 28.
To retrospectively investigate the impact of the electrode array diameter on local tumor progression after lung radiofrequency ablation.
This study included 651 lung tumors treated using multitined expandable electrodes and followed for ≥ 6 months. The mean long-axis tumor diameter was 12 mm ± 7 (range, 2-42 mm). The difference between electrode array diameter and tumor diameter (DAT) was used to investigate the impact of the electrode array diameter. All tumors were classified into 2 groups according to various variables including DAT (≥ 10 mm or < 10 mm). The primary technique efficacy rates were calculated using Kaplan-Meier analysis and compared between the 2 groups of each variable using the log-rank test. In addition, crude and multivariate multilevel survival analyses were performed by sequentially including DAT and the other variables in 5 models.
The median DAT for 651 tumors was 12 mm (range, -15 to 24 mm). The technique efficacy rate was significantly lower in the < 10 mm DAT group than in the ≥ 10 mm group (P < .001). In the crude and multivariate multilevel survival analyses, < 10 mm DAT was a significant risk factor for local progression in all models except model 5 (P = .067). In the ≥ 10 mm group, the technique efficacy rates were not significantly different between the 2 ≥ 10 mm DAT subgroups (10 to <15 mm DAT vs ≥ 15 mm DAT).
DAT is an important risk factor for local progression. We recommend an electrode that is ≥ 10 mm larger than the tumor diameter.
回顾性研究电极阵列直径对肺射频消融术后局部肿瘤进展的影响。
本研究纳入651例使用多针可扩张电极治疗且随访时间≥6个月的肺肿瘤患者。肿瘤平均长径为12 mm±7（范围2 - 42 mm）。用电极阵列直径与肿瘤直径之差（DAT）来研究电极阵列直径的影响。根据包括DAT（≥10 mm或<10 mm）在内的各种变量，将所有肿瘤分为2组。采用Kaplan-Meier分析计算主要技术有效率，并使用对数秩检验比较各变量2组之间的差异。此外，通过在5个模型中依次纳入DAT和其他变量进行粗多水平生存分析和多变量多水平生存分析。
651例肿瘤的DAT中位数为12 mm（范围 - 15至24 mm）。DAT < 10 mm组的技术有效率显著低于DAT≥10 mm组（P <.001）。在粗多水平生存分析和多变量多水平生存分析中，除模型5外（P = 0.067），DAT < 10 mm在所有模型中都是局部进展的显著危险因素。在DAT≥10 mm组中，DAT≥10 mm的2个亚组（10至<15 mm DAT与≥15 mm DAT）之间的技术有效率无显著差异。
DAT是局部进展的重要危险因素。我们建议使用比肿瘤直径大≥10 mm的电极。
