Zanus Giacomo, Tagliente Giovanni, Rossi Serena, Bonis Alessandro, Zambon Mattia, Scopelliti Michele, Brizzolari Marco, Grossi Ugo, Romano Maurizio, Finotti Michele
4th Surgery Unit, Regional Hospital Treviso, University of Padua, DISCOG, 31100 Padua, Italy.
Baylor Scott & White Annette C. and Harold C. Simmons Transplant Institute, Baylor University Medical Center, Dallas, TX 75204, USA.
Cancers (Basel). 2022 Jan 31;14(3):748. doi: 10.3390/cancers14030748.
This study aimed to analyze the outcomes of HCC patients treated with a novel technique-pulsed microwave ablation (MWA)-in terms of safety, local tumor progression (LTP), intrahepatic recurrence (IHR), and overall survival (OS). A total of 126 pulsed microwave procedures have been performed in our center. We included patients with mono- or multifocal HCC (BCLC 0 to D). The LTP at 12 months was 9.9%, with an IHR rate of 27.8% at one year. Survival was 92.0% at 12 months with 29.4% experiencing post-operative complications (28.6% Clavien-Dindo 1-2, 0.8% Clavien-Dindo 3-4). Stratifying patients by BCLC, we achieved BCLC 0, A, B, C, and D survival rates of 100%, 93.2%, 93.3%, 50%, and 100%, respectively, at one year, which was generally superior to or in line with the expected survival rates among patients who are started on standard treatment. The pulsed MWA technique is safe and effective. The technique can be proposed not only in patients with BCLC A staging but also in the highly selected cases of BCLC B, C, and D, confirming the importance of the concept of stage migration. This procedure, especially if performed with a minimally invasive technique (laparoscopic or percutaneous), is repeatable with a short postoperative hospital stay.
本研究旨在分析采用新技术——脉冲微波消融（MWA）治疗的肝癌患者在安全性、局部肿瘤进展（LTP）、肝内复发（IHR）和总生存期（OS）方面的结果。我们中心共进行了126例脉冲微波手术。我们纳入了单灶或多灶性肝癌（BCLC 0至D期）患者。12个月时的LTP为9.9%，一年时的IHR率为27.8%。12个月时的生存率为92.0%，29.4%的患者出现术后并发症（28.6%为Clavien-Dindo 1-2级，0.8%为Clavien-Dindo 3-4级）。按BCLC对患者进行分层，我们在一年时分别实现了BCLC 0、A、B、C和D期的生存率为100%、93.2%、93.3%、50%和100%，总体上优于或符合开始接受标准治疗患者的预期生存率。脉冲MWA技术安全有效。该技术不仅可用于BCLC A期患者，也可用于经过严格筛选的BCLC B、C和D期患者，这证实了分期迁移概念的重要性。该手术，尤其是采用微创技术（腹腔镜或经皮）进行时，具有可重复性且术后住院时间短。
