儿童多种肝脏肿物的立体定向射频消融术
Stereotactic radiofrequency ablation of a variety of liver masses in children.
作者信息
Hetzer Benjamin, Vogel Georg-Friedrich, Entenmann Andreas, Heil Michel, Schullian Peter, Putzer Daniel, Meister Bernhard, Crazzolara Roman, Kropshofer Gabriele, Salvador Christina, Straub Simon, Karall Daniela, Niederwanger Christian, Cortina Gérard, Janecke Andreas, Freund-Unsinn Karin, Maurer Kathrin, Schweigmann Gisela, Oberhuber Georg, Renz Oliver, Schneeberger Stefan, Müller Thomas, Bale Reto
机构信息
Department of Pediatrics I, Medical University of Innsbruck, Innsbruck, Austria.
Department of Radiology, Interventional Oncology-Microinvasive Therapy (SIP), Medical University of Innsbruck, Innsbruck, Austria.
出版信息
Int J Hyperthermia. 2020;37(1):1074-1081. doi: 10.1080/02656736.2020.1822549.
BACKGROUND AND AIMS
Surgical resection is currently the cornerstone of liver tumor treatment in children. In adults radiofrequency ablation (RFA) is an established minimally invasive treatment option for small focal liver tumors. Multiprobe stereotactic RFA (SRFA) with intraoperative image fusion to confirm ablation margins allows treatment for large lesions. We describe our experience with SRFA in children with liver masses.
METHODS
SRFA was performed in 10 patients with a median age of 14 years (range 0.5-17.0 years) suffering from liver adenoma ( = 3), hepatocellular carcinoma ( = 1), hepatoblastoma ( = 2), myofibroblastic tumor ( = 1), hepatic metastases of extrahepatic tumors ( = 2) and infiltrative hepatic cysts associated with alveolar echinococcosis ( = 1). Overall, 15 lesions with a mean lesion size of 2.6 cm (range 0.7-9.5 cm) were treated in 11 sessions.
RESULTS
The technical success rate was 100%, as was the survival rate. No transient adverse effects higher than grade II (Clavien and Dindo) were encountered after interventions. The median hospital stay was 5 d (range 2-33 d). In two patients who subsequently underwent transplant hepatectomy complete ablation was histologically confirmed. Follow-up imaging studies (median 55 months, range 18-129 months) revealed no local or distant recurrence of disease in any patient.
CONCLUSIONS
SRFA is an effective minimal-invasive treatment option in pediatric patients with liver tumors of different etiologies.
背景与目的
手术切除目前是儿童肝肿瘤治疗的基石。在成人中，射频消融（RFA）是小的局灶性肝肿瘤既定的微创治疗选择。术中图像融合以确认消融边缘的多探头立体定向RFA（SRFA）可用于治疗大的病变。我们描述了我们在患有肝脏肿块的儿童中使用SRFA的经验。
方法
对10例中位年龄为14岁（范围0.5 - 17.0岁）的患者进行了SRFA，这些患者患有肝腺瘤（n = 3）、肝细胞癌（n = 1）、肝母细胞瘤（n = 2）、肌纤维母细胞瘤（n = 1）、肝外肿瘤的肝转移（n = 2）以及与肺泡型棘球蚴病相关的浸润性肝囊肿（n = 1）。总共在11次治疗中治疗了15个病变，平均病变大小为2.6 cm（范围0.7 - 9.5 cm）。
结果
技术成功率和生存率均为100%。干预后未遇到高于II级（Clavien和Dindo）的短暂不良反应。中位住院时间为5天（范围2 - 33天）。在随后接受移植肝切除术的两名患者中，组织学证实完全消融。随访影像学研究（中位55个月，范围18 - 129个月）显示，所有患者均未出现局部或远处疾病复发。
结论
SRFA是治疗不同病因儿童肝肿瘤的一种有效的微创治疗选择。
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