Department of Ultrasound, Tianjin Third Central Hospital, Tianjin Key Laboratory of Artificial Cell, Tianjin, China.
Department of Gastroenterology and Hepatology, Tianjin Third Central Hospital, Tianjin, China.
Liver Int. 2017 Sep;37(9):1365-1372. doi: 10.1111/liv.13426. Epub 2017 Apr 12.
BACKGROUND & AIMS: To explore the long-term outcomes and safety of ultrasound-guided percutaneous microwave ablation (MWA) of exophytic tumours in hepatocellular carcinoma (HCC) patients.
One hundred and thirty-two patients with subcapsular HCC were enrolled in this retrospective study. These patients were divided into the exophytic group (n=71) and non-exophytic group (n=61) according to the location of the tumour(s). A special technology of puncture and ablation was performed to treat the exophytic tumours. The local tumour progression (LTP), progression free survival (PFS) and overall survival (OS) were analysed using Kaplan-Meier and Log-rank tests.
Sixty-nine of 71 exophytic tumours and 60 of 61 subcapsular tumours were completely ablated. The complete ablation rates were 97.2% and 98.4% respectively. The follow-up periods ranged from 6 to 62 months with a median of 31 months in the exophytic group, and ranged from 5 to 61 months, with a median of 27 months in the non-exophytic group. The 1-, 3- and 5-year cumulative LTP rates were 2.4%, 12.3%, 18.4% and 5.1%, 12.0%, 17.8% in the exophytic and non-exophytic groups respectively (P=.733). The 1-, 3- and 5-year OS rates were 100%, 75.7%, 52.9% and 95.0%, 73.8%, 61.5% in the exophytic group and non-exophytic group respectively (P=.980). There was no procedure-related mortality or major complication.
Ultrasound-guided percutaneous MWA is safe and effective for exophytic tumours in HCC patients. Treated by MWA, the HCC patients with exophytic tumours can get the similar local response and long-term outcome to those with non-exophytic subcapsular tumours.
探讨超声引导经皮微波消融（MWA）治疗肝细胞癌（HCC）患者外生型肿瘤的长期疗效和安全性。
本回顾性研究纳入了 132 例包膜下 HCC 患者。根据肿瘤位置将这些患者分为外生组（n=71）和非外生组（n=61）。采用特殊的穿刺和消融技术治疗外生型肿瘤。采用 Kaplan-Meier 和 Log-rank 检验分析局部肿瘤进展（LTP）、无进展生存期（PFS）和总生存期（OS）。
71 例外生型肿瘤中 69 例、61 例包膜下肿瘤中 60 例完全消融。完全消融率分别为 97.2%和 98.4%。外生组的随访时间为 662 个月，中位时间为 31 个月；非外生组的随访时间为 561 个月，中位时间为 27 个月。外生组和非外生组的 1、3 和 5 年累积 LTP 率分别为 2.4%、12.3%、18.4%和 5.1%、12.0%、17.8%（P=.733）。外生组和非外生组的 1、3 和 5 年 OS 率分别为 100%、75.7%、52.9%和 95.0%、73.8%、61.5%（P=.980）。无与操作相关的死亡或严重并发症。
超声引导经皮 MWA 治疗 HCC 患者的外生型肿瘤安全有效。MWA 治疗后，外生型肿瘤患者的局部反应和长期预后与非外生型包膜下肿瘤患者相似。
