计算机断层扫描引导下经皮冷冻消融和微波消融治疗血管周围型肝细胞癌：倾向评分匹配的对比研究

Computed tomography-guided percutaneous cryoablation and microwave ablation in the treatment of perivascular hepatocellular carcinoma: A comparative study with propensity score matching.

作者信息

Li Bing, Ren Zi Wang, Zhang Chuan, Yu Xiao Xuan, Xu Xiao Xue, Du Yong, Yang Han Feng

机构信息

Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong City, Sichuan Province, China.

出版信息

Clin Res Hepatol Gastroenterol. 2024 Mar;48(3):102298. doi: 10.1016/j.clinre.2024.102298. Epub 2024 Feb 15.

DOI:10.1016/j.clinre.2024.102298

PMID:38367802

Abstract

OBJECTIVE

To evaluate the safety and efficacy of cryoablation (CYA) and microwave ablation (MWA) in the treatment of patients with perivascular hepatocellular carcinoma (HCC).

METHODS

Patients with perivascular HCC who underwent computed tomography (CT)-guided percutaneous CYA or MVA treatment in our hospital from August 2009 to March 2019 were included. Propensity score matching (PSM) was performed to adjust for potential baseline differences in the two groups. The technical success rate (TS), complications, and visual analog scale (VAS) were analyzed. The overall survival (OS) was evaluated using Kaplan-Meier curves and Cox proportional hazards models.

RESULTS

After PSM, 32 patients from each group were selected. The technical success rate was 94 % for CYA and 91 % for MWA, and 13 patients developed recurrence (CYA, n = 5, 2 local, 3 distant; MWA, n = 8, 6 local, 2 distant). There were no significant differences in OS (36-months OS: CYA 53.1 % vs, MWA 40.6 %; P = 0.191). No intraoperative deaths or complication-related deaths were observed, and 19 patients (CYA, n = 8; MWA, n = 11) experienced complications (P = 0.435). The VAS in the MWA group (5.38 ± 1.21) was significantly higher than that in the CYA group (2.22 ± 0.87; P < 0.001).

CONCLUSIONS

While CYA has equal safety and high primary efficacy as MWA in the treatment of perivascular HCC, it is associated with less periprocedural pain.

摘要

目的

评估冷冻消融（CYA）和微波消融（MWA）治疗血管周围型肝细胞癌（HCC）患者的安全性和有效性。

方法

纳入2009年8月至2019年3月在我院接受计算机断层扫描（CT）引导下经皮CYA或MVA治疗的血管周围型HCC患者。采用倾向评分匹配（PSM）来调整两组潜在的基线差异。分析技术成功率（TS）、并发症和视觉模拟量表（VAS）。使用Kaplan-Meier曲线和Cox比例风险模型评估总生存期（OS）。

结果

PSM后，每组选择32例患者。CYA的技术成功率为94%，MWA为91%，13例患者出现复发（CYA组5例，2例局部复发，3例远处复发；MWA组8例，6例局部复发，2例远处复发）。OS无显著差异（36个月OS：CYA为53.1%，MWA为40.6%；P = 0.191）。未观察到术中死亡或与并发症相关的死亡，19例患者（CYA组8例，MWA组11例）出现并发症（P = 0.435）。MWA组的VAS（5.38±1.21）显著高于CYA组（2.22±0.87；P < 0.001）。