a Department of Radiology , The Second Hospital of Nanjing Nanjing University of Chinese Medicine , Nanjing , China.
b Department of Interventional Radiology , The Affiliated Central Hospital of Qingdao University , Qingdao , China.
Int J Hyperthermia. 2019;36(1):351-358. doi: 10.1080/02656736.2019.1571247. Epub 2019 Mar 8.
The aims of this study were to compare the clinical outcomes between ultrasound-guided percutaneous microwave ablation (US-PMWA) and surgical resection (SR) in patients with recurrent intrahepatic cholangiocarcinoma (ICC) and to identify the prognostic factors associated with the two treatment methods.
This retrospective study was institutional review board approved. A total of 121 patients (102 men and 19 women) with 136 ICCs after hepatectomy from April 2011 to January 2017 were reviewed. Fifty-six patients underwent US-PMWA and 65 patients underwent SR. Survival, recurrence and liver function were compared between the two groups. Effect of changes in key parameters [i.e., overall survival (OS) and recurrence-free survival (RFS)] was statistically analyzed with the log-rank test. Univariate and multivariate analysis were performed on clinicopathological variables to identify factors affecting long-term outcome.
The OS and RFS after MWA were comparable to that of SR (p = .405, and p = .589, respectively). Estimated 5-year OS rates were 23.7% after MWA and 21.8% after SR; for RFS, estimated 3-year RFS rates were 33.1% after MWA and 30.6% after SR. Major complication rates in SR group were higher than that in MWA (p < .001) (SR, 13.8% vs. MWA, 5.3%). Multivariate analysis showed tumor number (p = .012), ALBI grade (p = .007), and metastasis (p = .016), may become OS rate predictors.
US-PMWA had comparable oncologic outcomes with SR and could be a safe and effective treatment for recurrent ICC after hepatectomy.
本研究旨在比较超声引导经皮微波消融（US-PMWA）与手术切除（SR）治疗复发性肝内胆管癌（ICC）的临床疗效，并确定与两种治疗方法相关的预后因素。
本回顾性研究经机构审查委员会批准。共纳入 2011 年 4 月至 2017 年 1 月期间因肝切除术后复发的 136 例 ICC 患者，其中 56 例行 US-PMWA，65 例行 SR。比较两组患者的生存、复发和肝功能情况。采用 Log-rank 检验对影响总生存（OS）和无复发生存（RFS）的关键参数变化进行统计学分析。采用单因素和多因素分析对临床病理变量进行分析，以确定影响长期预后的因素。
MWA 后的 OS 和 RFS 与 SR 相当（p=0.405 和 p=0.589）。MWA 后 5 年 OS 率为 23.7%，SR 为 21.8%；RFS 方面，MWA 后 3 年 RFS 率为 33.1%，SR 为 30.6%。SR 组的主要并发症发生率高于 MWA 组（p<0.001）（SR，13.8%比 MWA，5.3%）。多因素分析显示，肿瘤数目（p=0.012）、ALBI 分级（p=0.007）和转移（p=0.016）可能成为 OS 率的预测因素。
US-PMWA 治疗复发性 ICC 的肿瘤学疗效与 SR 相当，是一种安全有效的治疗方法。
