Department of Minimally Invasive Interventional Radiology, Sun Yat-Sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine , Guangzhou , China.
Department of Breast Oncology, Sun Yat-Sen University Cancer Center , Guangzhou , China.
Int J Hyperthermia. 2019;36(1):1003-1011. doi: 10.1080/02656736.2019.1663279.
To evaluate the safety, efficacy, and survival outcomes of computed tomography (CT)-guided thermal ablation for adrenal metastases from hepatocellular carcinoma (HCC). This long-term retrospective study included 27 male patients (median age, 50 years; range, 34-77 years) with 29 adrenal metastatic tumors associated with HCC who underwent ablation between January 2004 and December 2015. The technical success rate, effectiveness rate, complications, and survival were recorded. Complications were assessed according to the Common Terminology Criteria for Adverse Events. Survival curves were estimated using the Kaplan-Meier method. A Cox regression model was used for the evaluation of factors predicting survival. A total of 33 ablation sessions were performed for the 29 tumors. No ablation-related death was observed, and the incidence of complications was 87.9%. Grade 1-2 complications occurred in 23 of the 33 sessions (69.7%), and grade 3 hypertension was the only major complication, occurring in eight sessions (24.2%). The technical success and effectiveness rates were 93.1% (27 of 29 tumors) and 92.6% (25 of 27 patients), respectively. The median progression-free survival and overall survival (OS) durations for the 27 patients were 6.9 months and 16.8 months, respectively. The median OS duration was longer for patients with adrenal oligometastases (21.8 months) than for those with (12.8 months) multiple metastases ( = .037). Adrenal oligometastases were the only significant predictor of OS ( = .043). CT-guided ablation is a feasible and safe procedure for adrenal metastases from HCC, and it may be more beneficial for patients with adrenal oligometastases.
评估计算机断层扫描（CT）引导下热消融治疗肝细胞癌（HCC）肾上腺转移的安全性、疗效和生存结果。这项长期回顾性研究纳入了 2004 年 1 月至 2015 年 12 月期间接受消融治疗的 27 例 HCC 肾上腺转移患者（男性，29 例肾上腺转移瘤），患者中位年龄 50 岁（范围 34-77 岁）。记录了技术成功率、有效率、并发症和生存情况。根据不良事件常用术语标准评估并发症。采用 Kaplan-Meier 法估计生存曲线。采用 Cox 回归模型评估预测生存的因素。为 29 个肿瘤进行了 33 次消融治疗。未观察到与消融相关的死亡，并发症发生率为 87.9%。23 次（69.7%）治疗中发生 1-2 级并发症，仅 8 次（24.2%）发生 3 级高血压这一严重并发症。29 个肿瘤中，27 个肿瘤的技术成功率和有效率分别为 93.1%（27/29）和 92.6%（25/27）。27 例患者的中位无进展生存期和总生存期分别为 6.9 个月和 16.8 个月。肾上腺寡转移患者的中位总生存期（21.8 个月）长于多发转移患者（12.8 个月）（ = .037）。肾上腺寡转移是总生存期的唯一显著预测因素（ = .043）。CT 引导下消融术是治疗 HCC 肾上腺转移的一种可行且安全的方法，对于肾上腺寡转移患者可能更有益。
