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经皮转移淋巴结消融术:冷冻消融与射频消融疗效和安全性比较的新认识。

Percutaneous Ablation of Metastatic Lymph Nodes: An Insight from the Comparison of Efficacy and Safety Between Cryoablation and Radiofrequency Ablation.

机构信息

2nd Department of Radiology, Medical School, University General Hospital "ATTIKON", National and Kapodistrian University of Athens,, 1 Rimini str, 12462, Haidari/Athens, Greece.

Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, Singapore, 308433, Singapore.

出版信息

Cardiovasc Intervent Radiol. 2022 Aug;45(8):1134-1140. doi: 10.1007/s00270-022-03191-2. Epub 2022 Jun 9.

Abstract

PURPOSE

To retrospectively compare efficacy and safety of computed tomography (CT)-guided percutaneous ablation of metastatic lymph nodes (LN) between cryoablation (CA) and radiofrequency ablation (RFA).

MATERIALS AND METHODS

A bi-central institutional database research identified 28 patients (42 metastatic LNs) who underwent percutaneous CT-guided ablation. RFA group included 18 patients/26 tumors; CA group included 10 patients/16 tumors. Contrast-enhanced CT or MRI was used for post-ablation follow-up. Patient and tumor characteristics, technical and clinical success on a per tumor and a per patient basis and complication rates were recorded, evaluated and compared between the 2 groups.

RESULTS

Both RFA and CA groups had the same median tumor size (2.00 vs. 2.20 cm, p = 0.257), the same median follow-up time (20.50 vs. 20.00 months, p = 0.923) and the same median length of hospital stay (1.00 vs. 1.00 days, p = 0.283). CA group had a higher median procedure time (110.50 vs. 52.00 min, p = 0.001). On a per lesion basis, the overall complete response post-ablation was 88.46% (23/26 lesions) in the RFA and 93.75% (15/16 lesions) in the CA group; no association was revealed between local tumor control and ablation technique (p = 0.709). No complications were recorded in both Groups. On a per patient basis, CA had a longer disease-free interval (24.00 vs. 14.50, p = 0.012) which, however, did not affect the overall survival between the two techniques (26.0 vs. 22.0, p = 0.099 for CA and RFA respectively).

CONCLUSION

Our limited data suggest that CT-guided RFA and CA are equally effective on terms of efficacy and safety for the treatment of metastatic lymph nodes.

摘要

目的

回顾性比较 CT 引导下经皮冷冻消融(CA)与射频消融(RFA)治疗转移性淋巴结(LN)的疗效和安全性。

材料与方法

一项双中心机构数据库研究纳入了 28 例(42 个转移性 LN)接受经皮 CT 引导下消融治疗的患者。RFA 组包括 18 例/26 个肿瘤;CA 组包括 10 例/16 个肿瘤。消融后采用增强 CT 或 MRI 进行随访。记录、评估并比较了两组患者和肿瘤特征、肿瘤和患者水平的技术和临床成功率及并发症发生率。

结果

RFA 组和 CA 组的肿瘤最大直径中位数分别为 2.00 cm 和 2.20 cm(p=0.257)、中位随访时间分别为 20.50 个月和 20.00 个月(p=0.923)、中位住院时间分别为 1.00 天和 1.00 天(p=0.283)。CA 组的中位手术时间较长(110.50 分钟比 52.00 分钟,p=0.001)。基于病灶,RFA 组的完全缓解率为 88.46%(23/26 个病灶),CA 组为 93.75%(15/16 个病灶);局部肿瘤控制与消融技术之间无关联(p=0.709)。两组均未发生并发症。基于患者,CA 组的无疾病间隔时间较长(24.00 个月比 14.50 个月,p=0.012),但这并未影响两种技术之间的总生存(CA 和 RFA 分别为 26.0 个月和 22.0 个月,p=0.099)。

结论

我们的有限数据表明,CT 引导下 RFA 和 CA 在转移性淋巴结治疗的疗效和安全性方面同样有效。

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