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肝脏肿瘤的射频消融:肝硬化肝脏与健康肝脏之间消融区体积无差异。

Radiofrequency Ablation of Liver Tumors: No Difference in the Ablation Zone Volume Between Cirrhotic and Healthy Liver.

作者信息

Cassinotto Christophe, Denys Alban, Gay Frédérique, Duran Rafael, Hocquelet Arnaud, Piron Lauranne, Guiu Boris

机构信息

Department of Radiology, St-Eloi University Hospital, Montpellier, France.

Department of Radiology, CHUV, Office BH10-119, Rue du Bugnon 46, 1011, Lausanne, Switzerland.

出版信息

Cardiovasc Intervent Radiol. 2018 Jun;41(6):905-911. doi: 10.1007/s00270-018-1898-z. Epub 2018 Feb 26.

Abstract

PURPOSE

The "oven effect" theory assumes that radiofrequency ablation (RFA) would be more efficient on tumors of cirrhotic livers. The aim of the study was to compare the size and volume of the ablation zone following RFA on tumors of cirrhotic versus healthy livers.

METHODS

One hundred and eleven patients who underwent RFA from 2011 to 2013 for the treatment of 140 liver tumors (83 hepatocellular carcinomas developed on a cirrhotic liver, i.e., "cirrhosis group," and 57 tumors developed on a healthy liver, mainly liver metastasis, i.e., "healthy liver group") using the same RFA device were retrospectively selected. The diameter and volume of the ablation zone were compared between groups at the end of the procedure (FU0), at first (FU1) and second follow-up (FU2) performed 1.6 months (± 19 days) and 4.7 months (± 40 days) post-RFA, respectively.

RESULTS

No differences in the size or volume of the ablation zone were found between groups at FU0 (36.5 ± 12 mm vs. 34.3 ± 10 mm, p = 0.5; and 28 ± 16 mm vs. 26.5 ± 16 mm, p = 0.6, respectively), FU1, or FU2. Similarly, no differences were found at FU0, FU1, or FU2 in the subgroups of tumors treated using a single radiofrequency application. The mean volume of the ablation zone decreased over time, by 33.3% at FU1 and 48.5% at FU2, without any difference between groups.

CONCLUSION

In contradiction to the "oven effect" theory, RFA achieves ablation zones of a comparable size and volume in cirrhotic and healthy livers.

摘要

目的

“热炉效应”理论认为,射频消融(RFA)对肝硬化肝脏肿瘤的治疗效果更佳。本研究旨在比较RFA治疗肝硬化肝脏肿瘤与健康肝脏肿瘤后消融区的大小和体积。

方法

回顾性选取2011年至2013年期间接受RFA治疗140例肝脏肿瘤的111例患者(83例肝细胞癌发生于肝硬化肝脏,即“肝硬化组”;57例肿瘤发生于健康肝脏,主要为肝转移,即“健康肝脏组”),所有患者使用同一RFA设备。分别在术后即刻(FU0)、首次随访(FU1,RFA术后1.6个月±19天)和第二次随访(FU2,RFA术后4.7个月±40天)时比较两组消融区的直径和体积。

结果

在FU0(分别为36.5±12mm vs. 34.3±10mm,p = 0.5;以及28±16mm vs. 26.5±16mm,p = 0.6)、FU1或FU2时,两组消融区的大小或体积均无差异。同样,在单次射频应用治疗的肿瘤亚组中,FU0、FU1或FU2时也未发现差异。消融区的平均体积随时间减小,FU1时减小33.3%,FU2时减小48.5%,两组间无差异。

结论

与“热炉效应”理论相反,RFA在肝硬化肝脏和健康肝脏中形成的消融区大小和体积相当。

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