Thamtorawat Somrach, Hicks Robert M, Yu Jenifer, Siripongsakun Surachate, Lin Wei-Chan, Raman Steven S, McWilliams Justin P, Douek Michael, Bahrami Simin, Lu David S K
Department of Radiology, David Geffen School of Medicine at the University of California, Los Angeles, California; Department of Radiology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand.
Albert Einstein College of Medicine, Bronx, New York.
J Vasc Interv Radiol. 2016 May;27(5):623-30. doi: 10.1016/j.jvir.2016.01.011. Epub 2016 Mar 21.
To evaluate preliminary outcomes after microwave ablation (MWA) of hepatocellular carcinoma (HCC) up to 5 cm and to determine the influence of tumor size.
Electronic records were searched for HCC and MWA. Between January 2011 and September 2014, 173 HCCs up to 5 cm were treated by MWA in 129 consecutive patients (89 men, 40 women; mean age, 66.9 y ± 9.5). Tumor characteristics related to local tumor progression and primary and secondary treatment efficacy were evaluated by univariate analysis. Outcomes were compared between tumors ≤ 3 cm and tumors > 3 cm.
Technical success, primary efficacy, and secondary efficacy were 96.5%, 99.4%, and 94.2% at a mean follow-up period of 11.8 months ± 9.8 (range, 0.8-40.6 mo). Analysis of tumor characteristics showed no significant risk factor for local tumor progression, including subcapsular location (P = .176), tumor size (P = .402), and perivascular tumor location (P = .323). The 1-year and 2-year secondary or overall treatment efficacy rates for tumors measuring ≤ 3 cm were 91.2% and 82.1% and for tumors 3.1-5 cm were 92.3% and 83.9% (P = .773). The number of sessions to achieve secondary efficacy was higher in the larger tumor group (1.13 vs 1.06, P = .005). There were three major complications in 134 procedures (2.2%).
With use of current-generation MWA devices, percutaneous ablation of HCCs up to 5 cm can be achieved with high efficacy.
评估直径达5 cm的肝细胞癌（HCC）经微波消融（MWA）后的初步疗效，并确定肿瘤大小的影响。
检索有关HCC和MWA的电子记录。2011年1月至2014年9月期间，129例连续患者（89例男性，40例女性；平均年龄66.9岁±9.5岁）的173个直径达5 cm的HCC接受了MWA治疗。通过单因素分析评估与局部肿瘤进展以及初次和二次治疗疗效相关的肿瘤特征。比较直径≤3 cm和直径>3 cm肿瘤的疗效。
在平均随访期11.8个月±9.8（范围0.8 - 40.6个月）时，技术成功率、初次疗效和二次疗效分别为96.5%、99.4%和94.2%。肿瘤特征分析显示，包括包膜下位置（P = 0.176）、肿瘤大小（P = 0.402）和血管周围肿瘤位置（P = 0.323）在内，均无局部肿瘤进展的显著危险因素。直径≤3 cm肿瘤的1年和2年二次或总体治疗有效率分别为91.2%和82.1%，直径3.1 - 5 cm肿瘤的为92.3%和83.9%（P = 0.773）。较大肿瘤组达到二次疗效的治疗次数更多（1.13比1.06，P = 0.005）。134例手术中有3例发生严重并发症（2.2%）。
使用当前一代MWA设备，可高效实现对直径达5 cm的HCC进行经皮消融。
