Vogl Thomas J, Freichel Jason, Gruber-Rouh Tatjana, Nour-Eldin Abdelrehim Nour-Eldin, Bechstein Wolf-Otto, Zeuzem Stefan, Naguib Nagy N N, Stefenelli Ulrich
Diagnostic and Interventional Radiology, Goethe University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt Am Main, Germany.
Department of Diagnostic and Interventional Radiology, Faculty of Medicine, Cairo University, Cairo, Egypt.
Heliyon. 2023 Mar 20;9(4):e14646. doi: 10.1016/j.heliyon.2023.e14646. eCollection 2023 Apr.
Purpose The purpose of the study is to retrospectively evaluate the development and technological progress in local oncological treatments of hepatocellular carcinoma (HCC) by means of ablation techniques like laser interstitial thermal therapy (LITT), microwave ablation (MWA) and transarterial chemoembolization (TACE) in a multimodal application. Method This retrospective single-center study uses data generated between 1993 and 2020 (1,045 patients). Therapy results are evaluated using survival rates of Kaplan-Meier estimator, Cox proportional hazard regression and log-rank test. Results Median survival times in group LITT (25 patients) are 1.6 years, and, 2.6 years for LITT + TACE (67 patients). For LITT only treatments 1-/3-/5-year survival rates scored 64%, 24% and 20%. Results for combined LITT + TACE treatments were 84%, 37% and 14%. Median survival time in group MWA (227 patients) is 4.5 years. Estimated median survival time for MWA + TACE (108 patients) leads to a median survival time of 2.7 years. In group MWA the 1-/3-/5-year survival rates are 85%, 54%, 45%. Group MWA + TACE shows values of 79%, 41% and 25%. A separate group of 618 patients has been analyzed with TACE as monotherapy. Median survival time of 1 year was estimated in this group. 1-/3-/5-year survival rates are 48%, 15% and 8%. - Cox regression analysis showed that the different treatment methods are statistically significant predictors for survival of patients. Conclusions Treatments with MWA resulted in best median survival rates, followed by MWA + TACE in combination. Survival rates of MWA only are significantly higher vs. LITT, vs. LITT + TACE and vs. TACE monotherapy.
目的 本研究旨在通过激光间质热疗（LITT）、微波消融（MWA）和经动脉化疗栓塞术（TACE）等消融技术在多模式应用中，回顾性评估肝细胞癌（HCC）局部肿瘤治疗的发展和技术进步。方法 这项回顾性单中心研究使用了1993年至2020年期间产生的数据（1045例患者）。使用Kaplan-Meier估计器的生存率、Cox比例风险回归和对数秩检验来评估治疗结果。结果 LITT组（25例患者）的中位生存时间为1.6年，LITT + TACE组（67例患者）为2.6年。仅LITT治疗的1年/3年/5年生存率分别为64%、24%和20%。LITT + TACE联合治疗的结果分别为84%、37%和14%。MWA组（227例患者）的中位生存时间为4.5年。MWA + TACE组（108例患者）的估计中位生存时间为2.7年。MWA组的1年/3年/5年生存率分别为85%、54%、45%。MWA + TACE组分别为79%、41%和25%。单独一组618例患者接受了TACE单药治疗分析。该组估计中位生存时间为1年。1年/3年/5年生存率分别为48%、15%和8%。 - Cox回归分析表明，不同的治疗方法是患者生存的统计学显著预测因素。结论 MWA治疗的中位生存率最佳，其次是MWA + TACE联合治疗。仅MWA的生存率显著高于LITT、LITT + TACE和TACE单药治疗。
