Ma Sicong, Ding Min, Li Jiang, Wang Tao, Qi Xingxing, Shi Yaoping, Ming Yanan, Chi Jiachang, Wang Zhi, Tang Xiaoyin, Cui Dan, Zhang Yuan, Zhai Bo
Department of Interventional Oncology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
Department of Viral and Gene Therapy, Eastern Hepatobiliary Surgery Hospital, The Second Military Medical University, Shanghai, China.
J Cancer Res Clin Oncol. 2017 Jan;143(1):131-142. doi: 10.1007/s00432-016-2266-5. Epub 2016 Sep 20.
The aim of this study was to evaluate the clinical outcomes of ultrasound-guided percutaneous microwave ablation (US-guided PMWA) for the treatment of hepatocellular carcinoma (HCC) with the analysis of prognostic factors.
The treatment and survival parameters of 433 patients with HCC (≤10 cm), who met the inclusion criteria and had received US-guided PMWA in Renji Hospital from July 2010 to November 2014, were retrospectively analyzed. Imaging examination (contrast-enhanced CT or MR) and tumor markers (AFP and CA199) 1 month after MWA were used to evaluate the efficacy of US-guided PMWA. SPSS software was used to perform all statistical analyses.
The initial complete ablation (CA) rate was 94.9 % (411/433). Twenty-two patients with incomplete ablation received repeat PMWA, and the total CA rate was up to 98.6 % (427/433). Multiple tumor number, tumor >5 cm in diameter, and higher serum AFP level (>20 ng/ml) were significant unfavorable prognosticators of progression-free survival (PFS). The cumulative 1-, 2-, and 3-year overall survival (OS) rates were 83.5, 66.1, and 58.7 %, respectively (median: 43 months). Tumor >5 cm in diameter and serum AFP >400 ng/ml were significant unfavorable prognosticators of OS.
PMWA is well tolerated in HCC patients and capable of offering high CA rate. Tumor number, tumor size, and AFP level were significant prognosticators of patients' PFS, whereas tumor size and AFP level were significant prognosticators of OS.
本研究旨在评估超声引导下经皮微波消融术（US引导下PMWA）治疗肝细胞癌（HCC）的临床疗效，并分析预后因素。
回顾性分析2010年7月至2014年11月在仁济医院接受US引导下PMWA治疗且符合纳入标准的433例HCC患者（肿瘤直径≤10 cm）的治疗及生存参数。采用MWA术后1个月的影像学检查（增强CT或MR）和肿瘤标志物（AFP和CA199）评估US引导下PMWA的疗效。使用SPSS软件进行所有统计分析。
初始完全消融（CA）率为94.9%（411/433）。22例消融不完全的患者接受了重复PMWA，总CA率高达98.6%（427/433）。肿瘤数目、肿瘤直径>5 cm以及血清AFP水平较高（>20 ng/ml）是无进展生存期（PFS）的显著不良预后因素。1年、2年和3年的累积总生存率（OS）分别为83.5%、66.1%和58.7%（中位数：43个月）。肿瘤直径>5 cm和血清AFP>400 ng/ml是OS的显著不良预后因素。
PMWA在HCC患者中耐受性良好，能够提供较高的CA率。肿瘤数目、肿瘤大小和AFP水平是患者PFS的显著预后因素，而肿瘤大小和AFP水平是OS的显著预后因素。
