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超声引导下经皮射频消融治疗尾状叶肝细胞癌的疗效分析

[Curative effect analysis of ultrasound-guided percutaneous radiofrequency ablation for caudate lobe hepatocellular carcinoma].

作者信息

Zhou Y Z, Zhu R L, Wang Z Z, Yu K L, Li Q J, Zhou J X

机构信息

Department of Hepatobiliary Pancreas Surgery, Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou 450008, China.

出版信息

Zhonghua Gan Zang Bing Za Zhi. 2021 Jul 20;29(7):690-695. doi: 10.3760/cma.j.cn501113-20191101-00403.

Abstract

To investigate the safety and efficacy of ultrasound-guided percutaneous radiofrequency ablation (RFA) for caudate lobe hepatocellular carcinoma (HCC) and the failure factors of incomplete tumor ablation. Twenty-four cases with caudate lobe hepatocellular carcinoma who underwent ultrasound-guided percutaneous RFA in the Affiliated Tumor Hospital of Zhengzhou University from January 2017 to October 2019 were enrolled. The ablation effect and complications conditions were recorded, and the primary technical effectiveness and local tumor progression (LTP) were evaluated. Among 24 cases, 20 cases had complete ablation at one session, 4 cases had incomplete ablation, and after supplementary radiofrequency ablation all cases had achieved complete ablation. There was no evidence of local tumor progression in 24 cases after one-month postoperative evaluation. The primary technical effectiveness rate was 100%. The postoperative follow-up was 2 to 29 months (median follow-up time was 18 months). Of the 24 cases after ablation, LTP were detected in 11 cases, of which only 3 cases had distant intrahepatic recurrence, 1 case had distant intrahepatic recurrence and distant metastasis, and 5 cases had only distant metastasis, 2 cases died, and 4 cases had SIR grade B complications related to ablation. Ultrasound-guided percutaneous radiofrequency ablation was safe and effective for caudate lobe hepatocellular carcinoma. In addition, the distance between the tumor and the inferior vena cava < 0.5cm is a suspected risk factor for incomplete ablation of caudate lobe hepatocellular carcinoma ( < 0.05).

摘要

探讨超声引导下经皮射频消融(RFA)治疗尾状叶肝细胞癌(HCC)的安全性和有效性以及肿瘤消融不完全的失败因素。纳入2017年1月至2019年10月在郑州大学附属肿瘤医院接受超声引导下经皮RFA治疗的24例尾状叶肝细胞癌患者。记录消融效果和并发症情况,评估主要技术有效性和局部肿瘤进展(LTP)。24例中,20例一次消融完全,4例消融不完全,补充射频消融后所有病例均实现完全消融。术后1个月评估,24例均无局部肿瘤进展证据。主要技术有效率为100%。术后随访2至29个月(中位随访时间为18个月)。24例消融后,11例检测到LTP,其中仅3例有肝内远处复发,1例有肝内远处复发和远处转移,5例仅有远处转移,2例死亡,4例有与消融相关的SIR B级并发症。超声引导下经皮射频消融治疗尾状叶肝细胞癌安全有效。此外,肿瘤与下腔静脉距离<0.5cm是尾状叶肝细胞癌消融不完全的可疑危险因素(<0.05)。

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