Tee Syer Ree, Hughes Hannah, Ryan Edmund Ronan, McCann Jeff, O'Rourke Colin, Bourke Michele, MacNicholas Ross, Cantwell Colin P, Healy Gerard M
Department of Radiology, St. Vincent's University Hospital, Dublin, Ireland.
School of Medicine, University College Dublin, Dublin, Ireland.
Can Assoc Radiol J. 2025 May;76(2):333-343. doi: 10.1177/08465371241286795. Epub 2024 Sep 29.
Image-guided tumour ablation is a minimally invasive treatment for early stage hepatocellular carcinoma (HCC). Our study reviews the complications and long term outcomes in patients treated at a tertiary referral centre. Retrospective study. All patients with HCC who underwent microwave ablation (MWA) or radiofrequency ablation (RFA) from 1st January 2014 to 31st December 2022 were identified. Treatment response of target lesion, complications, and survival were recorded. One hundred seventy ablations were performed in 118 patients; 70% MWA, 30% RFA. Median radiological follow-up 21 months (range 3-107). Follow-up imaging was reported using LI-RADS and mRECIST. At first follow-up imaging, 94 patients had complete response (primary efficacy rate 80.3%) while 19.7% (n = 23) had residual disease. Fifteen of these had repeat ablation; 10 had complete response (secondary efficacy rate 85.6%). By end of study duration, 70.5% (n = 79) achieved sustained local complete response from single ablation without documented recurrence. 14.3% (n = 16) required more than one ablation of target lesion. Overall, 84.8% (n = 95) demonstrated long term local complete response to ablation. Complication occurred in 5.9% (n = 10); 40.0% Grade I, 40.0% Grade II, 10.0% Grade III, 10.0% Grade IV as per the CIRSE Classification. 1-, 3-, and 5-year overall survival (OS) rate was 97%, 68%, and 61% respectively. Mean OS was 5.3 years (median 4.7). No difference in OS ( = .7) or local progression free survival ( = .5) between patients treated with MWA versus RFA. This study demonstrates excellent long-term response to TA, with acceptable complication profile. No difference in survival between RFA versus MWA.
影像引导下的肿瘤消融是早期肝细胞癌（HCC）的一种微创治疗方法。我们的研究回顾了在一家三级转诊中心接受治疗的患者的并发症和长期预后。回顾性研究。确定了2014年1月1日至2022年12月31日期间所有接受微波消融（MWA）或射频消融（RFA）的HCC患者。记录靶病变的治疗反应、并发症和生存率。对118例患者进行了170次消融；70%为MWA，30%为RFA。影像学中位随访时间为21个月（范围3 - 107个月）。使用LI-RADS和mRECIST报告随访影像。在首次随访影像检查时，94例患者获得完全缓解（主要有效率80.3%），而19.7%（n = 23）有残留病灶。其中15例进行了重复消融；10例获得完全缓解（次要有效率85.6%）。到研究结束时，70.5%（n = 79）通过单次消融实现了持续局部完全缓解且无复发记录。14.3%（n = 16）需要对靶病变进行不止一次消融。总体而言，84.8%（n = 95）显示出对消融的长期局部完全缓解。并发症发生率为5.9%（n = 10）；根据CIRSE分类，40.0%为I级，40.0%为II级，10.0%为III级，10.0%为IV级。1年、3年和5年总生存率（OS）分别为97%、68%和61%。平均OS为5.3年（中位值4.7年）。接受MWA与RFA治疗的患者在OS（P = 0.7）或局部无进展生存期（P = 0.5）方面无差异。本研究表明TA具有出色的长期反应，并发症情况可接受。RFA与MWA在生存率方面无差异。
