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经皮氩氦刀冷冻消融治疗毗邻大器官或大血管的小肝癌:单中心 92 例回顾性研究。

Percutaneous Argon-Helium Cryoablation for Small Hepatocellular Carcinoma Located Adjacent to a Major Organ or Viscus: A Retrospective Study of 92 Patients at a Single Center.

机构信息

Department of Liver Disease of Chinese People's Liberation Army (PLA) General Hospital, The Fifth Medical Center of Chinese PLA General Hospital, Beijing, China (mainland).

Department of Emergency Medicine, Beidaihe Sanatorium of the Joint Logistics Support Force of the Chinese People's Liberation Army, Beidaihe, Hebei, China (mainland).

出版信息

Med Sci Monit. 2021 Aug 13;27:e931473. doi: 10.12659/MSM.931473.

Abstract

BACKGROUND Cryoablation of hepatocellular carcinoma (HCC) close to major organs or viscus is challenging because it can cause complications. This retrospective study aimed to investigate the safety and efficacy of percutaneous argon-helium cryoablation of small HCC located adjacent to major organs or viscus. MATERIAL AND METHODS Ninety-two patients who underwent percutaneous argon-helium cryoablation between February 2012 and December 2018 at the Fifth Medical Center of the Chinese People's Liberation Army General Hospital were included. Treatment efficacy was evaluated by magnetic resonance imaging or triphasic computed tomography scan within 1 week after each cryoablation procedure. Local tumor progression, distant recurrence, and overall survival were analyzed using the Kaplan-Meier method and log-rank test. RESULTS A total of 92 patients with small HCC located adjacent to major organs or viscus who underwent cryoablation were retrospectively reviewed. The number of patients with tumors adjacent to the gallbladder, portal or hepatic vein, diaphragm, stomach, heart, and intestine was 22, 1, 39, 6, 8, and 16, respectively. Cumulative local tumor progression rates at 1 and 2 years were 2.8% and 7.3%, respectively. Cumulative distant recurrence rates at 1, 2, and 3 years were 11.1%, 17.6%, and 20.7%, respectively. The overall survival rates at 1, 2, and 4 years were 100%, 93.6%, and 74.9%, respectively. Major complications were observed in 5 (5.4%) patients. Minor complications were observed in 85 (92.4%) patients. CONCLUSIONS This experience from a single center showed that percutaneous argon-helium cryoablation was safe and effective in the management of small HCC that is located adjacent to major organs or viscus.

摘要

背景

靠近主要器官或内脏的肝细胞癌(HCC)的冷冻消融具有挑战性,因为它可能会导致并发症。本回顾性研究旨在探讨经皮氩氦冷冻消融治疗紧邻主要器官或内脏的小 HCC 的安全性和有效性。

材料和方法

2012 年 2 月至 2018 年 12 月,中国人民解放军总医院第五医学中心共对 92 例接受经皮氩氦冷冻消融的患者进行了回顾性分析。每次冷冻消融后 1 周内,通过磁共振成像或三期计算机断层扫描评估治疗效果。采用 Kaplan-Meier 法和对数秩检验分析局部肿瘤进展、远处复发和总体生存情况。

结果

共回顾了 92 例紧邻主要器官或内脏的小 HCC 患者的冷冻消融情况。肿瘤紧邻胆囊、门静脉或肝静脉、膈肌、胃、心脏和肠的患者分别为 22、1、39、6、8 和 16 例。1 年和 2 年的累积局部肿瘤进展率分别为 2.8%和 7.3%。1 年、2 年和 3 年的累积远处复发率分别为 11.1%、17.6%和 20.7%。1 年、2 年和 4 年的总生存率分别为 100%、93.6%和 74.9%。5 例(5.4%)患者发生主要并发症,85 例(92.4%)患者发生轻微并发症。

结论

本单中心经验表明,经皮氩氦冷冻消融治疗紧邻主要器官或内脏的小 HCC 安全有效。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/98b2/8369936/d20e4a47172d/medscimonit-27-e931473-g001.jpg

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