Department of Radiology, Severance Hospital, Research Institute of Radiological Science, Yonsei University College of Medicine, 50 Yonsei-ro Seodaemun-gu, Seoul 120-752, Korea.
Department of Radiology, Severance Hospital, Research Institute of Radiological Science, Yonsei University College of Medicine, 50 Yonsei-ro Seodaemun-gu, Seoul 120-752, Korea.
J Vasc Interv Radiol. 2019 Aug;30(8):1223-1228. doi: 10.1016/j.jvir.2018.12.030. Epub 2019 Apr 5.
This study evaluated the safety and efficacy of percutaneous cryoablation for treatment of the left subdiaphragmatic small hepatocellular carcinomas (HCCs) adjacent to the heart.
Between September 2013 and March 2018, 189 consecutive patients underwent cryoablation for small HCCs (≤3 cm); 70 patients (mean: 61.3 ± 10.6 years of age; range: 40-82 years) with left hepatic tumors (22 juxtacardiac and 48 nonjuxtacardiac tumors) were retrospectively analyzed. Patients were divided into juxtacardiac and nonjuxtacardiac tumor groups (tumor margins: ≤10 mm and >10 mm, respectively, from the heart border). The rates of technical success, complete ablation, complications, and local tumor recurrence (LTR) were evaluated.
No significant intergroup differences were observed in the mean diameter of the tumor (17.9 ± 5.5 mm vs. 17.5 mm ± 5.2, respectively; P = 0.781) and of the ablation zone (41.3 ± 4.2 mm vs. 43.5 ± 5.8 mm, respectively; P = 0.115). Technical success was achieved in all patients. No procedure-related major complications occurred in either group. The median follow-up period was 15 months (range: 3.1-49.6 months). No statistically significant intergroup differences were observed in the rates of complete ablation (90.9% vs. 93.8%, respectively; P = 0.646) and LTR (20% vs. 15.6%, respectively; P = 0.725).
Cryoablation is a safe treatment modality for patients with juxtacardiac small HCCs, without an increased risk of cardiac complications compared to treatment of HCCs that are nonjuxtacardiac, and with comparable efficacy.
本研究评估了经皮冷冻消融治疗毗邻心脏的左膈下小肝细胞癌（HCC）的安全性和疗效。
2013 年 9 月至 2018 年 3 月，189 例连续接受小 HCC（≤3cm）冷冻消融治疗的患者；回顾性分析其中 70 例（平均年龄：61.3±10.6 岁；范围：40-82 岁）左肝肿瘤患者（22 例毗邻心脏肿瘤和 48 例非毗邻心脏肿瘤）。患者被分为毗邻心脏肿瘤组和非毗邻心脏肿瘤组（肿瘤边缘分别距心脏边界≤10mm 和＞10mm）。评估技术成功率、完全消融率、并发症和局部肿瘤复发（LTR）率。
两组肿瘤平均直径（17.9±5.5mm 与 17.5mm±5.2mm，P=0.781）和消融区直径（41.3±4.2mm 与 43.5±5.8mm，P=0.115）无显著组间差异。所有患者均达到技术成功。两组均无与手术相关的严重并发症。中位随访时间为 15 个月（范围：3.1-49.6 个月）。两组完全消融率（90.9%与 93.8%，P=0.646）和 LTR 率（20%与 15.6%，P=0.725）无显著组间差异。
与非毗邻心脏 HCC 治疗相比，冷冻消融治疗毗邻心脏小 HCC 是一种安全的治疗方法，不增加心脏并发症的风险，且疗效相当。
