Department of Medical Ultrasonics, The Eighth Affiliated Hospital of Sun Yat-sen University, No. 3025, Shennanzhong Road, Shenzhen, 518033, PR China.
Department of Medical Ultrasonics, The Eighth Affiliated Hospital of Sun Yat-sen University, No. 3025, Shennanzhong Road, Shenzhen, 518033, PR China.
Clin Res Hepatol Gastroenterol. 2021 Sep;45(5):101581. doi: 10.1016/j.clinre.2020.11.011. Epub 2021 Mar 21.
To explore the value of ultrasound fusion imaging for the thermal ablation of medium-sized hepatocellular carcinomas (HCCs).
From December 2010 to June 2018, patients with medium-sized (3.1-5.0cm) HCCs who underwent radiofrequency ablation (RFA) or microwave ablation (MWA) with the assistance of ultrasound fusion imaging were enrolled in this retrospective study. Technical efficacy, local tumor progression (LTP), intrahepatic distant recurrence (IDR), overall survival (OS), tumor-free survival (TFS) and major complications were evaluated during the follow-up period. The therapeutic outcomes were compared between the RFA/MWA combined with trans-arterial chemoembolization (TACE) group and the RFA/MWA alone group with propensity-score matching (PSM) analysis.
A total of 112 patients with 115 medium-sized HCCs were finally enrolled in this study. The median duration of follow-up was 33 months (range, 2-104 months). The technique efficacy was 100% (115/115). The 1-, 3-, 5-year OS rates and TFS rates were 95.5%, 76.7%, 71.5% and 74.1%, 48.7%, 41.8%, respectively. The corresponding LTP rates and IDR rates were 5.4%, 7.3%, 7.3% and 21.8%, 46.9%, 50.3%, respectively. The incidence of major complications was 5.4% (6/112). After PSM analysis (19 patients in each group), the therapeutic outcomes, including the OS, TFS, and LTP rates, were comparable in the two groups (P > 0.05).
With the assistance of ultrasound fusion imaging, thermal ablation of medium-sized HCC could achieve a satisfactory local control rate and long-term survival. The outcomes were comparable in the stratified analysis between the RFA/MWA alone group and the RFA/MWA+TACE group after PSM analysis.
探讨超声融合成像在中等大小肝细胞癌（HCC）热消融中的应用价值。
本回顾性研究纳入了 2010 年 12 月至 2018 年 6 月期间接受超声融合成像引导下射频消融（RFA）或微波消融（MWA）治疗的中等大小（3.1-5.0cm）HCC 患者。评估技术疗效、局部肿瘤进展（LTP）、肝内远处复发（IDR）、总生存期（OS）、无瘤生存期（TFS）和主要并发症。采用倾向性评分匹配（PSM）分析比较 RFA/MWA 联合肝动脉化疗栓塞（TACE）组与 RFA/MWA 单独组的治疗效果。
共纳入 112 例 115 个中等大小 HCC 患者，中位随访时间为 33 个月（范围 2-104 个月）。技术疗效为 100%（115/115）。1、3、5 年 OS 率和 TFS 率分别为 95.5%、76.7%、71.5%和 74.1%、48.7%、41.8%。相应的 LTP 率和 IDR 率分别为 5.4%、7.3%、7.3%和 21.8%、46.9%、50.3%。主要并发症发生率为 5.4%（6/112）。PSM 分析后（每组 19 例），两组的 OS、TFS 和 LTP 率等治疗结果比较，差异均无统计学意义（P＞0.05）。
在超声融合成像的辅助下，中等大小 HCC 的热消融可获得满意的局部控制率和长期生存率。PSM 分析后，在 RFA/MWA 单独组与 RFA/MWA+TACE 组的分层分析中，结果相似。
