CT引导下经皮微波消融治疗肝细胞癌：单中心经验
Percutaneous Microwave Ablation Under CT Guidance for Hepatocellular Carcinoma: a Single Institutional Experience.
作者信息
Pusceddu Claudio, Melis Luca, Ballicu Nicola, Sotgia Barbara, Melis Marcovalerio, Sanna Valeria, Meloni Giovanni Battista, Porcu Alberto, Fancellu Alessandro
机构信息
Division of Interventional Radiology, Department of Oncological Radiology, Oncological Hospital A. Businco, Cagliari, Italy.
New York University School of Medicine and Department of Surgery, NY Harbor Healthcare System VAMC, New York, NY, USA.
出版信息
J Gastrointest Cancer. 2018 Sep;49(3):295-301. doi: 10.1007/s12029-017-9951-8.
BACKGROUND
Microwave ablation (MWA) is an emerging treatment for treatment of patients with hepatocellular carcinoma (HCC) not amenable of surgical resection.
PATIENTS AND METHODS
We searched for patients diagnosed as having small-, medium-, and large HCCs treated with MWA under CT guidance between 2010 and 2014. The main outcomes of interest were rates of complete ablation, complications, and overall survival. Rates of complete ablation were compared with Chi-square test, and estimated survival rates were calculated by means of Kaplan-Meier method.
RESULTS
Thirty-two patients with 45 HCC nodules received MWA. Seventeen (37.8%) nodules were <3 cm (small), 15 (33.3%) between 3 and 5 cm (medium), and 13 (28.9%) > 5 cm (large). Complete ablation was obtained in 94.1% of small tumors, 80% of medium tumors, and 53.8% of large tumors (p = 0.03). Two patients had HCC located in risk area (paracardiac position). Minor complications occurred after seven procedures (15.5%). Estimated median survival was 37 months (95% confidence interval 11.97-62.02). One-year OS was 82.7%, 2-year survival 68.9%, and 3-year survival 55.2%.
CONCLUSION
MWA is a versatile ablative method that can be applied in HCC at various stages, and also in lesions located in risk areas.
背景
微波消融（MWA）是一种新兴的治疗方法，用于治疗无法进行手术切除的肝细胞癌（HCC）患者。
患者与方法
我们检索了2010年至2014年间在CT引导下接受MWA治疗的小、中、大肝癌患者。主要关注的结果是完全消融率、并发症和总生存率。采用卡方检验比较完全消融率，通过Kaplan-Meier法计算估计生存率。
结果
32例患者共45个HCC结节接受了MWA治疗。17个（37.8%）结节<3 cm（小），15个（33.3%）在3至5 cm之间（中），13个（28.9%）>5 cm（大）。小肿瘤的完全消融率为94.1%，中肿瘤为80%，大肿瘤为53.8%（p = 0.03）。2例患者的HCC位于危险区域（心旁位置）。7例手术（15.5%）后出现轻微并发症。估计中位生存期为37个月（95%置信区间11.97 - 62.02）。1年总生存率为82.7%，2年生存率为68.9%，3年生存率为55.2%。
结论
MWA是一种通用的消融方法，可应用于不同阶段的HCC，也可应用于位于危险区域的病变。
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