Dumoutier Antoine, Nicolas Aymeric, Bonnet Baptiste, Touchefeu Yann, Meyer Jeremy, Douane Frederic, Frampas Eric, Tselikas Lambros, David Arthur
Department of Diagnostic and Interventional Radiology, CHU Nantes, Nantes, France.
Department of Anaesthesiology, Surgery and Interventional Radiology, Gustave Roussy, Villejuif, France.
Abdom Radiol (NY). 2025 May;50(5):2294-2303. doi: 10.1007/s00261-024-04655-4. Epub 2024 Nov 2.
Managing hepatocellular carcinoma (HCC) in patients with a transjugular intrahepatic portosystemic shunt (TIPS) is becoming increasingly common. This study aimed to evaluate the safety and efficacy of percutaneous thermal ablation for treating HCC in patients with TIPS.
This retrospective longitudinal study was conducted at Nantes University Hospital. The main inclusion criteria were patients undergoing percutaneous thermal ablation for HCC. Patients with a pre-existing TIPS were included in the 'TIPS group'. A 1:1 control group without TIPS, the 'n-TIPS group', was created for this case-control study. The primary endpoints were overall survival and progression-free survival over 12 months. Safety was assessed by comparing complications between the groups.
Between 2008 and 2020, 371 patients underwent percutaneous thermal ablation for HCC. The 'TIPS group' included 34 patients (66 nodules), while 34 patients (84 nodules) were randomly assigned to the 'n-TIPS group.' Overall survival rates at 1 year were 97% and 94% respectively (p = 0.52). The progression-free survival rate was 68% and 57% respectively (p = 0.35). No deaths occurred within 30 days post-procedure. There were 3 immediate complications in the TIPS group and 4 in the n-TIPS group (p = 1), none of which were related to the TIPS, including thrombosis.
Percutaneous thermal ablation for HCC in patients with TIPS appears to be as safe and effective as in TIPS-naïve patients. These results suggest that the presence of a TIPS should not be considered a contraindication for percutaneous thermal ablation in treating HCC.
经颈静脉肝内门体分流术（TIPS）患者的肝细胞癌（HCC）管理正变得越来越普遍。本研究旨在评估经皮热消融治疗TIPS患者HCC的安全性和有效性。
本回顾性纵向研究在南特大学医院进行。主要纳入标准为接受经皮热消融治疗HCC的患者。已存在TIPS的患者被纳入“TIPS组”。为该病例对照研究设立了一个1:1的无TIPS对照组，即“非TIPS组”。主要终点为12个月内的总生存期和无进展生存期。通过比较两组间的并发症来评估安全性。
2008年至2020年期间，371例患者接受了经皮热消融治疗HCC。“TIPS组”包括34例患者（66个结节），而34例患者（84个结节）被随机分配至“非TIPS组”。1年时的总生存率分别为97%和94%（p = 0.52）。无进展生存率分别为68%和57%（p = 0.35）。术后30天内无死亡发生。TIPS组有3例即刻并发症，非TIPS组有4例（p = 1），均与TIPS无关，包括血栓形成。
TIPS患者经皮热消融治疗HCC似乎与未行TIPS的患者一样安全有效。这些结果表明，TIPS的存在不应被视为经皮热消融治疗HCC的禁忌证。
