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微波消融对肝脏恶性肿瘤生存率和复发率的影响。

Impact of microwave ablation on survival rates and recurrence in hepatic malignant tumors.

作者信息

Shi Jutian, Jiang Yutian, Li Jinpeng, Chen Hua, Cong Ning

机构信息

Intervention Ward One, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, No. 440, Jiyan Road, Huaiyin District, Jinan, 250000, Shandong Province, China.

Department of Interventional, Yan Tai Yu Huangding Hospital, Yan Tai, 264000, China.

出版信息

Clin Transl Oncol. 2025 Mar;27(3):1131-1141. doi: 10.1007/s12094-024-03626-x. Epub 2024 Aug 13.

DOI:10.1007/s12094-024-03626-x
PMID:39136926
Abstract

PURPOSE

This study aimed to evaluate the efficacy of percutaneous microwave ablation (MWA) for treating hepatic malignant tumors and to identify factors influencing tumor recurrence post-treatment.

METHODS

A total of 249 patients with hepatic malignant tumors treated at the Shandong Cancer Hospital and Institute were included, and 101 patients were analyzed. Disease-free and overall survival rates were assessed at 1, 2, and 3 years post-MWA. Correlations between tumor recurrence and factors such as Child-Pugh B classification and lesion count were examined, and a meta-analysis was conducted to identify independent risk factors for recurrence.

RESULTS

The study found disease-free survival rates of 80.2%, 72.3%, and 70.3% at 1, 2, and 3 years post-MWA, with overall survival rates at 99%, 97%, and 96%. Significant correlations were observed between tumor recurrence, Child-Pugh B classification, and the number of lesions. Meta-analysis confirmed lesion count and Child-Pugh B classification as independent risk factors for recurrence following MWA treatment.

CONCLUSION

The study underscores the importance of considering Child-Pugh B classification and lesion count in predicting tumor recurrence after MWA for hepatic malignant tumors. These findings offer valuable insights for clinicians in decision-making and post-treatment monitoring.

摘要

目的

本研究旨在评估经皮微波消融(MWA)治疗肝脏恶性肿瘤的疗效,并确定影响治疗后肿瘤复发的因素。

方法

纳入在山东省肿瘤医院暨山东省肿瘤防治研究院接受治疗的249例肝脏恶性肿瘤患者,对其中101例患者进行分析。在MWA治疗后1年、2年和3年评估无病生存率和总生存率。研究肿瘤复发与Child-Pugh B级分类和病灶数量等因素之间的相关性,并进行荟萃分析以确定复发的独立危险因素。

结果

研究发现MWA治疗后1年、2年和3年的无病生存率分别为80.2%、72.3%和70.3%,总生存率分别为99%、97%和96%。观察到肿瘤复发、Child-Pugh B级分类和病灶数量之间存在显著相关性。荟萃分析证实病灶数量和Child-Pugh B级分类是MWA治疗后复发的独立危险因素。

结论

本研究强调了在预测肝脏恶性肿瘤MWA治疗后肿瘤复发时考虑Child-Pugh B级分类和病灶数量的重要性。这些发现为临床医生的决策和治疗后监测提供了有价值的见解。

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本文引用的文献

1
Management of Hepatocellular Carcinoma: A Review.肝细胞癌的管理:综述
JAMA Surg. 2023 Apr 1;158(4):410-420. doi: 10.1001/jamasurg.2022.7989.
2
Surgical approach to microwave and radiofrequency liver ablation for hepatocellular carcinoma and colorectal liver metastases less than 5 cm: a systematic review and meta-analysis.微波和射频消融治疗小于 5cm 的肝细胞癌和结直肠癌肝转移的手术入路:系统评价和荟萃分析。
Surg Endosc. 2023 May;37(5):3340-3353. doi: 10.1007/s00464-022-09815-5. Epub 2022 Dec 21.
3
Evidence on percutaneous radiofrequency and microwave ablation for liver metastases over the last decade.
近十年经皮射频和微波消融治疗肝转移瘤的证据。
Jpn J Radiol. 2022 Oct;40(10):1035-1045. doi: 10.1007/s11604-022-01335-5. Epub 2022 Sep 13.
4
Hepatocellular carcinoma.肝细胞癌
Lancet. 2022 Oct 15;400(10360):1345-1362. doi: 10.1016/S0140-6736(22)01200-4. Epub 2022 Sep 6.
5
Prognosis and treatment pattern of advanced hepatocellular carcinoma after failure of first-line atezolizumab and bevacizumab treatment.一线阿替利珠单抗联合贝伐珠单抗治疗失败的晚期肝细胞癌的预后和治疗模式。
Hepatol Int. 2022 Oct;16(5):1199-1207. doi: 10.1007/s12072-022-10392-x. Epub 2022 Aug 20.
6
Rethinking the Barcelona clinic liver cancer guidelines: Intermediate stage and Child-Pugh B patients are suitable for surgery?重新思考巴塞罗那临床肝癌指南:中期和 Child-Pugh B 患者适合手术吗?
World J Gastroenterol. 2021 Jun 7;27(21):2784-2794. doi: 10.3748/wjg.v27.i21.2784.
7
Changes in and challenges regarding the surgical treatment of hepatocellular carcinoma in China.中国肝细胞癌外科治疗的变化与挑战。
Biosci Trends. 2021 Jul 6;15(3):142-147. doi: 10.5582/bst.2021.01083. Epub 2021 Mar 14.
8
Meta-Analysis.荟萃分析
Chest. 2020 Jul;158(1S):S97-S102. doi: 10.1016/j.chest.2020.03.003.
9
Role of thermal ablation in the management of colorectal liver metastasis.热消融在结直肠癌肝转移治疗中的作用。
Hepatobiliary Surg Nutr. 2020 Feb;9(1):49-58. doi: 10.21037/hbsn.2019.06.08.
10
Child-Pugh Classification: Time to Abandon?Child-Pugh 分级:是时候摒弃了吗?
Semin Liver Dis. 2019 Feb;39(1):96-103. doi: 10.1055/s-0038-1676805. Epub 2019 Jan 11.