Suwa Kanehiko, Seki Toshihito, Tsuda Rinako, Yamashina Masao, Murata Miki, Yamaguchi Takashi, Nishio Akiyoshi, Okazaki Kazuichi
The Third Department of Internal Medicine, Division of Gastroenterology and Hepatology, Kansai Medical University, Hirakata, Osaka 573-1101, Japan.
Kansai Medical University Medical Center, Liver Disease Center, Moriguchi, Osaka 570-8507, Japan.
Mol Clin Oncol. 2020 Mar;12(3):230-236. doi: 10.3892/mco.2020.1983. Epub 2020 Jan 21.
The aim of the present study was to evaluate the efficacy and safety of the new-generation percutaneous microwave ablation (MWA) compared with the radiofrequency ablation (RFA) system for the treatment of hepatocellular carcinoma (HCC). A retrospective study was conducted from January 2014 to February 2019. A total of 44 patients and 52 nodules (mean tumor size, 17.2±4.9 mm) were treated with MWA, and 55 patients and 70 nodules (mean tumor size, 17.7±6.4 mm) were treated with RFA. After 4 days of treatment, the direct effects of ablation were assessed using dynamic CT, and after discharge, a follow-up dynamic CT scan was performed every 3-4 months. Treatment efficacy, complications and local recurrence were recorded. For MWA and RFA, the average number of CT sessions were 1.05±0.23 and 1.28±0.54, respectively, and the mean ablation times were 5.0±2.0 and 8.1±4.8 min. Following MWA and RFA, the ablation ranges that were evaluated with the axial images were 31.9±5.5 and 33.3±9.0 mm, respectively, in the long-axis diameter and 27.6±5.3 and 23.4±6.8 mm, respectively, in the short-axis diameter. The flatness ratios of the ablation regions were 0.13±0.09 and 0.29±0.14 (axial image) and 0.11±0.07 and 0.28±0.14 (coronal image), respectively. The rates of complete tumor necrosis were comparable. The complication rates were 13.6% (MWA) and 14.5% (RFA), which were not significantly different. The cumulative local recurrence rates were not significantly different between the two methods (one-year recurrence rate, MWA: 6.91%, RFA: 5.17%). MWA was therefore indicated to be an effective treatment for HCC in respect to session number, treatment time and spherical ablation.
本研究旨在评估新一代经皮微波消融(MWA)与射频消融(RFA)系统治疗肝细胞癌(HCC)的疗效和安全性。对2014年1月至2019年2月进行了一项回顾性研究。共有44例患者和52个结节(平均肿瘤大小为17.2±4.9毫米)接受了MWA治疗,55例患者和70个结节(平均肿瘤大小为17.7±6.4毫米)接受了RFA治疗。治疗4天后,使用动态CT评估消融的直接效果,出院后每3-4个月进行一次随访动态CT扫描。记录治疗效果、并发症和局部复发情况。对于MWA和RFA,CT检查的平均次数分别为1.05±0.23和1.28±0.54,平均消融时间分别为5.0±2.0和8.1±4.8分钟。MWA和RFA后,通过轴向图像评估的消融范围在长轴直径上分别为31.9±5.5和33.3±9.0毫米,在短轴直径上分别为27.6±5.3和23.4±6.8毫米。消融区域的扁平率分别为0.13±0.09和0.29±0.14(轴向图像)以及0.11±0.07和0.28±0.14(冠状图像)。肿瘤完全坏死率相当。并发症发生率分别为13.6%(MWA)和14.5%(RFA),无显著差异。两种方法的累积局部复发率无显著差异(一年复发率,MWA:6.91%,RFA:5.17%)。因此,就检查次数、治疗时间和球形消融而言,MWA被认为是治疗HCC的有效方法。