Schullian Peter, Laimer Gregor, Johnston Edward, Putzer Daniel, Eberle Gernot, Widmann Gerlig, Scharll Yannick, Bale Reto
Department of Radiology, Section of Interventional Oncology-Microinvasive Therapy (SIP), Medical University of Innsbruck, Anichstr. 35, 6020 Innsbruck, Austria.
The Royal Marsden Hospital, 203 Fulham Road, Chelsea, London SW3 6JJ, UK.
Biology (Basel). 2023 Jan 22;12(2):175. doi: 10.3390/biology12020175.
To compare the results of a novice with those of experienced interventional radiologists (IRs) for stereotactic radiofrequency ablation (SRFA) of malignant liver tumors in terms of safety, technical success, and local tumor control.
A database, including all SRFA procedures performed in a single center between January 2011 and December 2018 was retrospectively analyzed. A total of 39 ablation sessions performed by a novice IR were compared to the results of three more experienced IRs. Comparative SRFA sessions were selected using propensity score matching considering tumor type, age, sex, tumor size, and tumor number as matching variables. Overall, 549 target tumors were treated in 273 sessions. Median tumor size was 2.2 cm (1.0-8.5 cm) for 178 hepatocellular carcinomas (HCCs) and 3.0 cm (0.5-13.0 cm) for 371 metastases. A median of 2 (1-11) tumors were treated per session.
No significant differences were observed when comparing the results of more experienced IRs with those of a novice IR regarding the rates of major complications (6.8% [16/234] vs. 5.1% [2/39]; = 0.477), mortality (1.3% [2/234] vs. 0% [0/39]; = 0.690), primary technical efficacy (98.5% [525/533] vs. 98.9% [94/95]; = 0.735), and local recurrence (5.6% [30/533] vs. 5.3% [5/95]; = 0.886). However, the median planning/placement time was significantly shorter for the experienced IRs (92 min vs. 119 min; = 0.002).
SRFA is a safe, effective, and reliable treatment option for malignant liver tumors and favorable outcomes can be achieved even by inexperienced operators with minimal supervision.
比较新手与经验丰富的介入放射科医生（IR）进行立体定向射频消融（SRFA）治疗恶性肝肿瘤在安全性、技术成功率和局部肿瘤控制方面的结果。
回顾性分析一个数据库，该数据库包含2011年1月至2018年12月在单一中心进行的所有SRFA手术。将新手IR进行的39次消融手术结果与另外三名经验更丰富的IR的结果进行比较。使用倾向得分匹配法选择对比的SRFA手术，将肿瘤类型、年龄、性别、肿瘤大小和肿瘤数量作为匹配变量。总体而言，在273次手术中治疗了549个目标肿瘤。178例肝细胞癌（HCC）的中位肿瘤大小为2.2 cm（1.0 - 8.5 cm），371例转移瘤的中位肿瘤大小为3.0 cm（0.5 - 13.0 cm）。每次手术治疗的肿瘤中位数为2个（1 - 11个）。
在比较经验更丰富的IR与新手IR的结果时，未观察到重大并发症发生率（6.8% [16/234] 对5.1% [2/39]；P = 0.477）、死亡率（
