From the Minimally Invasive Interventional Division, Medical Imaging Center, State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, Collaborative Innovation Center for Cancer Medicine, 651 Dongfeng Road East, Guangzhou 510060, People's Republic of China (T.P., Q.K.X, N.L., L.W.M., P.H.W., M.Z.); Department of Vascular Interventional Radiology, the Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China (T.P.); and Department of Interventional Radiology, Guangzhou First People's Hospital, Guangzhou Medical University, Guangzhou, China (X.S.L.).
Radiology. 2017 Jan;282(1):259-270. doi: 10.1148/radiol.2016151807. Epub 2016 Jul 11.
Purpose To assess the effectiveness and safety of percutaneous computed tomography (CT)-guided radiofrequency ablation (RFA) for lymph node (LN) oligometastases from hepatocellular carcinoma (HCC). Materials and Methods This retrospective study was approved by the institutional ethics committee, and all patients provided written informed consent. From January 2004 to December 2013, 119 consecutive patients with HCC and LN oligometastases (115 men [mean age, 51.3 years; age range, 16-83 years] and four women [mean age, 38.2 years; age range, 23-47 years]) were included in this study. A matched cohort composed of 46 patients from each group was selected after adjustment with propensity score matching. The median follow-up time was 14.0 months in the RFA group and 13.8 months in the non-RFA group. The overall survival (OS), local control rate, and complications were evaluated. Survival curves were constructed with the Kaplan-Meier method and compared by using the log-rank test. Results Eighty-seven patients had LN metastases located in the regional site, and 32 patients had LN metastases in the distant site. No significant differences were observed in the baseline characteristics between groups after propensity score matching adjustment. The RFA group showed higher 6-month and 1-year OS rates compared with the non-RFA group (87.0% and 58.3% vs 62.4% and 17.9%, respectively; P = .001). The 3-month local control rate after RFA was 84.4%, including complete response in 71.1% of patients and partial response in 13.3%. The complications of RFA were short-term abdominal pain and self-limited local hematoma, which occurred in 10 patients (21.7%) and five patients (10.9%), respectively. Conclusion Percutaneous CT-guided RFA may be a safe and effective treatment for the LN oligometastases generated by HCC. RSNA, 2016.
评估经皮 CT 引导下射频消融（RFA）治疗肝细胞癌（HCC）淋巴结寡转移的有效性和安全性。
本回顾性研究经机构伦理委员会批准，所有患者均签署书面知情同意书。2004 年 1 月至 2013 年 12 月，共纳入 119 例 HCC 伴淋巴结寡转移患者（男 115 例，平均年龄 51.3 岁；年龄范围，1683 岁；女 4 例，平均年龄 38.2 岁；年龄范围，2347 岁）。经倾向评分匹配后，每组各选取 46 例患者组成匹配队列。RFA 组和非 RFA 组的中位随访时间分别为 14.0 个月和 13.8 个月。评估两组患者的总生存（OS）率、局部控制率和并发症。采用 Kaplan-Meier 法绘制生存曲线，并用对数秩检验进行比较。
87 例患者的淋巴结转移位于区域部位，32 例患者的淋巴结转移位于远处部位。经倾向评分匹配调整后，两组患者的基线特征无显著差异。RFA 组患者的 6 个月和 1 年 OS 率均高于非 RFA 组（分别为 87.0%和 58.3%比 62.4%和 17.9%；P =.001）。RFA 治疗后 3 个月的局部控制率为 84.4%，包括完全缓解 71.1%，部分缓解 13.3%。RFA 相关并发症为短期腹痛和自限性局部血肿，分别发生于 10 例（21.7%）和 5 例（10.9%）患者。
经皮 CT 引导下 RFA 治疗 HCC 淋巴结寡转移安全有效。RSNA，2016 年。
