Medical School of Chinese PLA; Department of Interventional Ultrasound, The First Medical Center of Chinese PLA General Hospital, Beijing, China.
Department of Medical Administration, the 305th Hospital of Chinese PLA, Beijing, China.
J Cancer Res Ther. 2022 Apr;18(2):378-383. doi: 10.4103/jcrt.jcrt_1067_21.
This study aims to compare the clinical efficacy and safety between ultrasound (US)-guided percutaneous microwave ablation (MWA) assisted with a three-dimensional (3D) visualization preoperative planning system and surgical resection (SR) for hepatocellular carcinoma (HCC) in the caudate lobe.
Forty-nine patients diagnosed with caudate lobe HCC, who underwent US-guided percutaneous MWA (29 patients) or SR (20 patients), were enrolled between November 2005 and December 2018. Follow-up was performed at 1, 3, 6, 12, 18, 24, and 36 months after ablation or resection. The follow-up endpoint was recurrence or patient death. Overall survival (OS) and progression-free survival (PFS) were the primary outcomes, whereas local tumor progression (LTP), intrahepatic recurrence, and extrahepatic metastasis were the secondary ones.
The mean age of the two groups was 61.4 ± 9.1 (MWA) and 53.1 ± 6.8 (SR), respectively, with a significant difference (P < 0.01). There were no significant differences in OS (69.0% in the MWA group and 75.0% in the SR group) and PFS (62.1% in the MWA group and 35.3% in the SR group). LTP, intrahepatic recurrence, and extrahepatic recurrence were 6.9% (2/29), 31.0% (9/29), and 20.7% (6/29) in the MWA group and 5.0% (1/20), 60.0% (12/20), and 5.0% (1/20) in the SR group. The MWA group was more cost-effective and required less hospitalization time. No major complications were observed.
US-guided percutaneous MWA for HCC in the caudate lobe assisted with a 3D visualization preoperative planning system is an optional treatment with less expenses and shorter hospitalization than SR.
本研究旨在比较超声引导经皮微波消融（MWA）联合三维（3D）可视化术前规划系统与手术切除（SR）治疗肝尾状叶肝细胞癌（HCC）的临床疗效和安全性。
2005 年 11 月至 2018 年 12 月，共纳入 49 例经超声引导经皮 MWA（29 例）或 SR（20 例）治疗的肝尾状叶 HCC 患者。消融或切除后 1、3、6、12、18、24 和 36 个月进行随访。随访终点为复发或患者死亡。总生存期（OS）和无进展生存期（PFS）为主要结局，局部肿瘤进展（LTP）、肝内复发和肝外转移为次要结局。
两组患者的平均年龄分别为 61.4±9.1（MWA）和 53.1±6.8（SR），差异有统计学意义（P＜0.01）。MWA 组和 SR 组的 OS（69.0%和 75.0%）和 PFS（62.1%和 35.3%）差异无统计学意义。MWA 组的 LTP、肝内复发和肝外复发率分别为 6.9%（2/29）、31.0%（9/29）和 20.7%（29/29），SR 组分别为 5.0%（1/20）、60.0%（12/20）和 5.0%（1/20）。MWA 组更具成本效益，住院时间更短。未观察到严重并发症。
超声引导经皮 MWA 联合 3D 可视化术前规划系统治疗肝尾状叶 HCC 是一种可选的治疗方法，其费用低于 SR，住院时间也更短。
