Department of Ultrasound, Second Affiliated Hospital of Fujian Medical University, Quanzhou, China.
Department of Anesthesiology, Second Affiliated Hospital of Fujian Medical University, Quanzhou, China.
J Ultrasound Med. 2023 Aug;42(8):1779-1788. doi: 10.1002/jum.16198. Epub 2023 Feb 25.
To assess the efficacy and safety of ultrasound-guided percutaneous ablation (US-PA) for adrenal metastases (AMs) using a meta-analysis.
A systematic search of PubMed, Cochrane, Web of Science, and Embase electronic databases was performed to identify studies on US-PA for AM. Seven studies published between January 2000 and August 2022 were analyzed, which resulted in a sample size of 140 patients. Both random effects and common effects meta-analysis models were used to analyze the following efficacy and safety outcomes: the first and secondary technical success rate, 1-year overall survival rates, 1-year local tumor control rate, incidence rate of intraoperative hypertensive crises, and major complications. The subgroup analysis was performed to explore the origin of heterogeneity.
Among 140 patients from 7 studies included in this meta-analysis: 51 (36.43%) underwent radiofrequency ablation (RFA), and 89 (63.57%) underwent microwave ablation (MWA). Pooled data analysis revealed that the first and secondary technical success rates were 85% (95% confidence interval [CI], 73-96) and 99% (95% CI, 96-100), the 1-year overall survival rate was 83% (95% CI, 71-93), the 1-year local tumor control rate was 83% (95% CI, 75-90), and the incidence rate of intraoperative hypertensive crises was 14% (95% CI, 8-20). The overall rate of major complications was 3.6%. In the subgroup analysis, lower heterogeneity was indicated to be associated with mean tumor size and ablation type.
This meta-analysis showed that US-PA can be both effective and safe for AM in terms of overall survival, technical success rate, and local control for AM.
通过荟萃分析评估超声引导经皮消融（US-PA）治疗肾上腺转移瘤（AMs）的疗效和安全性。
系统检索 PubMed、Cochrane、Web of Science 和 Embase 电子数据库，以确定 US-PA 治疗 AM 的研究。分析了 2000 年 1 月至 2022 年 8 月期间发表的 7 项研究，共纳入 140 例患者。采用随机效应和固定效应荟萃分析模型分析以下疗效和安全性结局：首次和二次技术成功率、1 年总生存率、1 年局部肿瘤控制率、术中高血压危象发生率和主要并发症发生率。进行亚组分析以探讨异质性的来源。
在纳入的 7 项荟萃分析研究中，共 140 例患者：51 例（36.43%）接受射频消融（RFA）治疗，89 例（63.57%）接受微波消融（MWA）治疗。汇总数据分析显示，首次和二次技术成功率分别为 85%（95%可信区间，73%-96%）和 99%（95%可信区间，96%-100%），1 年总生存率为 83%（95%可信区间，71%-93%），1 年局部肿瘤控制率为 83%（95%可信区间，75%-90%），术中高血压危象发生率为 14%（95%可信区间，8%-20%）。主要并发症总发生率为 3.6%。在亚组分析中，肿瘤平均大小和消融方式与较低的异质性相关。
本荟萃分析表明，US-PA 治疗 AM 的总生存率、技术成功率和局部肿瘤控制率均较为有效和安全。
