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立体定向射频消融作为肝切除术后复发性 HCC 的一线治疗方法。

Stereotactic radiofrequency ablation as first-line treatment of recurrent HCC following hepatic resection.

机构信息

Department of Radiology, Microinvasive Therapy instead of Section of Microinvasive Therapy, Medical University of Innsbruck, Anichstr. 35, 6020, Innsbruck, Austria.

Radiology and Imaging Sciences, National Institutes of Health, Bethesda, MD, USA.

出版信息

Eur J Surg Oncol. 2020 Aug;46(8):1503-1509. doi: 10.1016/j.ejso.2020.03.207. Epub 2020 Mar 19.

Abstract

BACKGROUND

To evaluate the therapeutic efficacy, safety and overall clinical outcome of multiprobe stereotactic RF ablation (SRFA) as first-line treatment of HCC recurrence after hepatic resection (HR).

STUDY DESIGN

In this retrospective single-center study, 34 consecutive patients with previous HR were treated by SRFA between 2006 and 2018 for 140 HCCs in 60 ablation sessions.

RESULTS

The median treated tumor size was 3.0 cm (range 0.5-10 cm). SRFA was primarily successful for 133/140 (95%) tumors. Four tumors were successfully retreated, resulting in a secondary technical efficacy rate of 97.9%. Local tumor recurrence developed in 4 of 140 tumors (2.9%). The major complication rate was 4.8% (3 of 60 ablations). No periprocedural deaths occurred. The overall survival (OS) rates at 1-, 3-, and 5- years from the date of the first SRFA were 94.0%, 70.2%, and 53.3%, respectively, with a median OS of 69.1 months (95% CI 18.8-119.3). The disease-free survival (DFS) was 52.6%, 19.7% and 15.8%, at 1-, 3- and 5- years, respectively, with a median DFS of 12.8 months (95% CI 9.0-28.9).

CONCLUSION

Stereotactic RFA is a safe, feasible and useful option in the management of recurrent HCC following HR with low morbidity paired with good clinical outcome.

摘要

背景

评估多探针立体定向射频消融 (SRFA) 作为肝切除 (HR) 后 HCC 复发的一线治疗的疗效、安全性和总体临床结果。

研究设计

在这项回顾性单中心研究中,2006 年至 2018 年间,34 例先前接受 HR 的患者在 60 次消融治疗中接受了 SRFA 治疗,共治疗了 140 个 HCC。

结果

中位治疗肿瘤大小为 3.0cm(范围 0.5-10cm)。SRFA 主要成功治疗了 133/140 个(95%)肿瘤。4 个肿瘤成功进行了二次治疗,二次技术疗效率为 97.9%。140 个肿瘤中有 4 个(2.9%)发生局部肿瘤复发。主要并发症发生率为 4.8%(60 次消融中有 3 次)。无围手术期死亡。首次 SRFA 后 1、3 和 5 年的总生存率(OS)分别为 94.0%、70.2%和 53.3%,中位 OS 为 69.1 个月(95%CI 18.8-119.3)。无病生存率(DFS)分别为 52.6%、19.7%和 15.8%,1、3 和 5 年时的中位 DFS 为 12.8 个月(95%CI 9.0-28.9)。

结论

立体定向 RFA 是 HR 后 HCC 复发患者的一种安全、可行且有效的治疗选择,具有低发病率和良好的临床结果。

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