a Department of Medical Ultrasonics , The Sixth Affiliated Hospital of Sun Yat-Sen University , Guangzhou , China.
b Department of Gastrointestinal Surgery , The Sixth Affiliated Hospital of Sun Yat-Sen University , Guangzhou , China.
Int J Hyperthermia. 2019;36(1):36-43. doi: 10.1080/02656736.2018.1528511. Epub 2018 Nov 29.
To investigate the clinical effectiveness and safety of ultrasound (US)-guided percutaneous microwave ablation (MWA) for colorectal liver metastasis (CRLM) and evaluate the influencing factors of local efficacy.
From January 2013 to January 2017, 137 CRLM patients accepting US-guided percutaneous MWA were included. The 2450-MHz microwave ablation system and a cooled-shaft antenna were used. All patients were regularly followed up for at least 6 months. Technical success, complete ablation, local tumor progression (LTP), complications and side effects were assessed. Logistic regression analysis was used to identify the independent prognostic factors for LTP.
In total, 411 lesions (mean diameter 15.4 ± 7.2 mm, range 5-67 mm) were treated. Complete ablation was achieved in 99.27% (408/411) of lesions and 97.81% (134/137) of patients. LTP occurred in 5.35% (22/411) of lesions and 16.06% (22/137) of patients. LTP was more likely to occur in lesions larger than 3 cm in diameter (OR: 14.71; p < .001; 95% CI: 3.7 3-57.92), near a large vascular structure (OR: 7.04; p < .001; 95% CI: 2.41-20.60), near the diaphragm (OR: 4.02; p = .049; 95% CI: 1.05-16.11) and in patients with no response to chemotherapy before MWA (OR: 3.25; p = .032; 95% CI: 1.14-15.30). MWA was well tolerated, with a major complication rate of 3.65%, a minor complication rate of 8.03% and a mortality rate of 0%. Fever and pain were the most common side effects after MWA.
US-guided percutaneous MWA of CRLM is a safe and effective method that is expected to become a routine treatment for local tumor control of CRLM.
探讨超声引导经皮微波消融（MWA）治疗结直肠癌肝转移（CRLM）的临床疗效和安全性，并评估局部疗效的影响因素。
本研究回顾性分析了 2013 年 1 月至 2017 年 1 月期间 137 例接受超声引导经皮 MWA 的 CRLM 患者的临床资料。采用 2450MHz 微波消融系统和冷轴天线。所有患者均定期随访至少 6 个月。评估技术成功率、完全消融、局部肿瘤进展（LTP）、并发症和副作用。采用 Logistic 回归分析识别 LTP 的独立预后因素。
共治疗 411 个病灶（平均直径 15.4±7.2mm，范围 5-67mm）。99.27%（408/411）的病灶和 97.81%（134/137）的患者达到完全消融。5.35%（22/411）的病灶和 16.06%（22/137）的患者发生 LTP。病灶直径大于 3cm（OR：14.71；p<0.001；95%CI：3.7-57.92）、靠近大血管结构（OR：7.04；p<0.001；95%CI：2.41-20.60）、靠近膈肌（OR：4.02；p=0.049；95%CI：1.05-16.11）和 MWA 前无化疗反应的患者（OR：3.25；p=0.032；95%CI：1.14-15.30）更易发生 LTP。MWA 耐受性良好，主要并发症发生率为 3.65%，次要并发症发生率为 8.03%，死亡率为 0%。MWA 后最常见的副作用是发热和疼痛。
超声引导经皮 MWA 治疗 CRLM 是一种安全有效的方法，有望成为 CRLM 局部肿瘤控制的常规治疗方法。
