Interventional Oncology-Microinvasive Therapy (SIP), Department of Radiology, Medical University Innsbruck, Innsbruck, Austria.
INNPATH, Institute of Pathology, Tirol Kliniken Innsbruck, Innsbruck, Austria.
Int J Hyperthermia. 2022;39(1):780-787. doi: 10.1080/02656736.2022.2082562.
This study aimed to assess the safety and efficacy of stereotactic radiofrequency ablation (SRFA) in patients with hepatocellular adenomas (HCA).
Retrospective analyses of all patients referred for SRFA treatment at our institution between January 2010 and October 2020 revealed 14 patients (10 women; mean age 34.4 [range, 17-73 years]) with 38 HCAs treated through 18 ablation sessions. Ablations were considered successful if a safety margin >5 mm was achieved. Demographic, interventional, and outcome data were collected and analyzed. Primary and secondary technical efficacy rates were assessed based on follow-up images consisting of contrast-enhanced CT or MR scans.
The mean tumor size was 22 mm (range, 7-75 mm). Overall, 37/38 (97.4%) tumors were successfully ablated at the initial SRFA (primary efficacy rate of 97.4%). The median follow-up duration was 49.6 months. No deaths or adenoma-related complications (hemorrhage or malignant transformation) were observed. Disease-free survival rates at 1, 3, and 5 years from the date of the first SRFA were 100%, 85.8%, and 85.8%, respectively. Two patients developed new distant tumors retreated with consecutive re-ablation. No major complications occurred during any of the 18 ablation sessions.
Percutaneous thermal ablation is efficient in the treatment of HCAs and may thus be considered a valid first-line treatment option. In addition, SRFA allows for an effective, minimally invasive treatment of large and multiple hepatic tumors within one session.
本研究旨在评估立体定向射频消融（SRFA）治疗肝细胞腺瘤（HCA）患者的安全性和疗效。
对 2010 年 1 月至 2020 年 10 月期间在我院接受 SRFA 治疗的所有患者进行回顾性分析，共纳入 14 例（10 例女性；平均年龄 34.4 岁[范围，17-73 岁]）患者的 38 个 HCA，通过 18 次消融治疗。如果达到>5mm 的安全边界，则认为消融成功。收集并分析了患者的人口统计学、介入和结果数据。根据增强 CT 或 MRI 扫描的随访图像评估主要和次要技术疗效。
肿瘤平均直径为 22mm（范围，7-75mm）。总的来说，38 个肿瘤中有 37 个（97.4%）在初始 SRFA 时成功消融（初始疗效率为 97.4%）。中位随访时间为 49.6 个月。未观察到死亡或与腺瘤相关的并发症（出血或恶性转化）。首次 SRFA 后 1、3 和 5 年的无疾病生存率分别为 100%、85.8%和 85.8%。2 例患者出现新的远处肿瘤，行连续再消融。18 次消融治疗中均未发生重大并发症。
经皮热消融治疗 HCA 效果显著，可作为一种有效的一线治疗选择。此外，SRFA 可在一次治疗中对多个较大的肝脏肿瘤进行有效、微创的治疗。
