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超声融合成像辅助下微波消融治疗结直肠癌肝转移:一项基于肿瘤大小和位置的分层分析研究

Microwave ablation for colorectal liver metastases with ultrasound fusion imaging assistance: a stratified analysis study based on tumor size and location.

作者信息

Lin Jia, Liu Huahui, Liang Shuang, Luo Liping, Guan Sainan, Wu Shanshan, Liu Ying, Xu Shuxian, Yan Ronghua, Xu Erjiao

机构信息

Department of Medical Ultrasonics, The Eighth Affiliated Hospital of Sun Yat-Sen University, NO.3025 Shennan Middle Road, Shenzhen, 518000, Guangdong Province, China.

Department of Radiology, Peking University Shenzhen Hospital, NO.1120 Lianhua Road, Shenzhen, 518000, Guangdong Province, China.

出版信息

Abdom Radiol (NY). 2025 Jan;50(1):400-408. doi: 10.1007/s00261-024-04508-0. Epub 2024 Aug 2.

Abstract

PURPOSE

To investigate the efficacy of ultrasound fusion imaging-assisted microwave ablation (MWA) for patients with colorectal liver metastases (CRLM) based on stratified analysis of tumor size and location.

METHODS

Patients with CRLM who underwent ultrasound fusion imaging-assisted MWA in our hospital between February 2020 and February 2023 were enrolled into this retrospective study. Ultrasound fusion imaging was used for detection, guidance, monitoring and immediate evaluation throughout the MWA procedures. Technical success, technique efficacy, local tumor progression (LTP), intrahepatic progression and overall survival (OS) were recorded and analyzed. The subgroup analysis of intrahepatic progression of MWA for CRLM was performed according to tumor size and location.

RESULTS

A total of 51 patients with 122 nodules were enrolled. Both technical success and technique efficacy were acquired in all nodules. In a median follow-up period of 19 months, 2.5% of the nodules (3/122) were observed LTP. The 1-year and 2-year cumulative intrahepatic progression rates were 38.7% and 52.1% respectively. Patients were divided into subgroups according to tumor size (≥ 30 mm, n = 13; < 30 mm, n = 38) and tumor location (perivascular, n = 20; non-perivascular, n = 31 and subcapsular, n = 36; non-subcapsular, n = 15). The cumulative intrahepatic progression rates were similar between the subgroups regarding tumor size and perivascular location, while significantly higher in the subcapsular group than in the non-subcapsular group (p = 0.021).

CONCLUSION

Ultrasound fusion imaging-assisted MWA exhibited satisfactory local efficacy for CRLM, especially for non-subcapsular tumors.

摘要

目的

基于肿瘤大小和位置的分层分析,探讨超声融合成像辅助微波消融(MWA)治疗结直肠癌肝转移(CRLM)患者的疗效。

方法

纳入2020年2月至2023年2月在我院接受超声融合成像辅助MWA治疗的CRLM患者进行这项回顾性研究。在整个MWA过程中,超声融合成像用于检测、引导、监测和即时评估。记录并分析技术成功率、技术疗效、局部肿瘤进展(LTP)、肝内进展和总生存期(OS)。根据肿瘤大小和位置对CRLM患者进行MWA肝内进展的亚组分析。

结果

共纳入51例患者,122个结节。所有结节均获得技术成功和技术疗效。中位随访期为19个月,观察到2.5%的结节(3/122)出现LTP。1年和2年累积肝内进展率分别为38.7%和52.1%。根据肿瘤大小(≥30mm,n = 13;<30mm,n = 38)和肿瘤位置(血管周围,n = 20;非血管周围,n = 31;包膜下,n = 36;非包膜下,n = 15)将患者分为亚组。肿瘤大小和血管周围位置亚组之间的累积肝内进展率相似,而包膜下组显著高于非包膜下组(p = 0.021)。

结论

超声融合成像辅助MWA对CRLM显示出令人满意的局部疗效,尤其是对非包膜下肿瘤。

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