Kim Gyoung Min, Won Jong Yun, Kim Man Deuk, Park Sung Il, Lee Do Yun, Shin Wonseon, Shin Minwoo, Han Kwang-Hyub, Kim Do Young, Kim Seung Up
Department of Radiology and Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea.
Department of Internal Medicine, Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Republic of Korea.
Cardiovasc Intervent Radiol. 2016 Oct;39(10):1447-54. doi: 10.1007/s00270-016-1384-4. Epub 2016 Jun 2.
The aim of this study was to evaluate the safety and effectiveness of cryoablation in the treatment of subcapsular hepatocellular carcinoma (HCC) adjacent to various organs.
Twenty-eight patients with subcapsular HCC were treated with cryoablation in our institution. The degree of peri-procedural pain was measured using the visual analog scale (VAS). Technical success, local tumor progression, and overall disease progression rates were calculated. Procedure-related complications were identified by reviewing electronic medical records. Biochemical data, including serum aspartate aminotransferase (AST), alanine aminotransferase (ALT), and total bilirubin levels before and after the procedure were collected.
Subcapsular HCC tumors were located near the gallbladder, colon, stomach, kidney, diaphragm, or abdominal wall. The technical success rate of cryoablation was 96.4 % (27/28). Local recurrence- and progression-free survival rates were 96 and 84 % at 6 months, and 82 and 43 % at 1 year, respectively. All patients survived during the follow-up period. The VAS pain score ranged from 0 to 3 (mean, 1.57). A major complication occurred in one patient (3.6 %) and minor complications occurred at a rate of 17.9 %. Transient elevations of serum AST, ALT, and bilirubin levels were observed.
Cryoablation is a safe and an effective procedure for the treatment of subcapsular HCC adjacent to various major organs.
本研究旨在评估冷冻消融治疗邻近各种器官的肝包膜下肝细胞癌（HCC）的安全性和有效性。
28例肝包膜下HCC患者在我院接受冷冻消融治疗。采用视觉模拟量表（VAS）测量围手术期疼痛程度。计算技术成功率、局部肿瘤进展率和总体疾病进展率。通过查阅电子病历确定与手术相关的并发症。收集手术前后的生化数据，包括血清天冬氨酸转氨酶（AST）、丙氨酸转氨酶（ALT）和总胆红素水平。
肝包膜下HCC肿瘤位于胆囊、结肠、胃、肾、膈肌或腹壁附近。冷冻消融的技术成功率为96.4%（27/28）。6个月时局部复发和无进展生存率分别为96%和84%，1年时分别为82%和43%。所有患者在随访期间均存活。VAS疼痛评分范围为0至3分（平均1.57分）。1例患者发生严重并发症（3.6%），轻微并发症发生率为17.9%。观察到血清AST、ALT和胆红素水平短暂升高。
冷冻消融是治疗邻近各种主要器官的肝包膜下HCC的一种安全有效的方法。
