肝门周围肝细胞癌的射频消融：倾向评分匹配分析

Radiofrequency ablation for peribiliary hepatocellular carcinoma: propensity score matching analysis.

作者信息

Cui Jin, Sui Xinzi, Liu Kaiwen, Huang Min, Zheng Yuanwen, Zhao Xinya, Wang Gongzheng, Wang Ximing

机构信息

Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China.

Department of Radiology, Linyi People's Hospital, Linyi, China.

出版信息

Insights Imaging. 2025 Feb 19;16(1):45. doi: 10.1186/s13244-025-01919-5.

DOI:10.1186/s13244-025-01919-5

PMID:39971810

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11839967/

Abstract

OBJECTIVES

At present, there are no established clinical guidelines for radiofrequency ablation (RFA) of peribiliary hepatocellular carcinoma (HCC). Therefore, the aim of this study was to compare the long-term outcomes of RFA for peribiliary vs. non-peribiliary HCC.

METHODS

This retrospective study included 282 patients with peribiliary HCC (n = 109) or non-peribiliary HCC (n = 173) who received RFA between February 2013 and May 2021. Local tumor progression (LTP), overall survival (OS), disease-free survival (DFS), and complications were compared before and after propensity score matching (PSM).

RESULTS

Before PSM, there were no significant differences in 5-year LTP rates (26.3% vs. 23.6%, p = 0.602), OS rates (56.6% vs. 68.0%, p = 0.586), or DFS rates (22.9% vs. 25.7%, p = 0.239) between the peribiliary and non-peribiliary groups. After PSM, there were no significant differences in the 1-, 3-, and 5-year LTP rates (13.0%, 23.1%, and 26.3% vs. 12.1%, 25.1%, and 28.2%, respectively, p = 0.857), OS rates (97.2%, 73.5%, and 56.6% vs. 95.3%, 79.5%, and 70.6%, p = 0.727), or DFS rates (59.4%, 29.4%, and 22.9% vs. 64.2%, 33.1%, and 23.8%, p = 0.568) between the peribiliary non-peribiliary groups. Peribiliary location was not a significant prognostic factor for LTP (p = 0.622) or OS (p = 0.587). In addition, mild intrahepatic bile duct dilatation was more frequent in the peribiliary group (9.2% vs. 2.8%, p = 0.045).

CONCLUSION

Long-term outcomes of RFA were similar for peribiliary and non-peribiliary HCC. RFA is a viable alternative for treatment of peribiliary HCC.

CRITICAL RELEVANCE STATEMENT

The local tumor progression (LTP), overall survival (OS), and disease-free survival (DFS) rates after radiofrequency ablation (RFA) were similar for peribiliary and non-peribiliary hepatocellular carcinoma (HCC).

KEY POINTS

There are currently no clinical guidelines for radiofrequency ablation (RFA) of peribiliary hepatocellular carcinoma (HCC). Local tumor progression, overall survival, and disease-free survival after RFA were similar for peribiliary and non-peribiliary HCC. RFA is a viable alternative for the treatment of peribiliary HCC.

摘要

目的

目前，对于肝门周围肝细胞癌（HCC）的射频消融（RFA）尚无既定的临床指南。因此，本研究的目的是比较肝门周围与非肝门周围HCC行RFA后的长期疗效。

方法

本回顾性研究纳入了2013年2月至2021年5月期间接受RFA的282例肝门周围HCC患者（n = 109）或非肝门周围HCC患者（n = 173）。在倾向评分匹配（PSM）前后比较局部肿瘤进展（LTP）、总生存期（OS）、无病生存期（DFS）和并发症。

结果

在PSM前，肝门周围组与非肝门周围组之间的5年LTP率（26.3%对23.6%，p = 0.602）、OS率（56.6%对68.0%，p = 0.586）或DFS率（22.9%对25.7%，p = 0.239）无显著差异。PSM后，肝门周围组与非肝门周围组之间的1年、3年和5年LTP率（分别为13.0%、23.1%和26.3%对12.1%、25.1%和28.2%，p = 0.857）、OS率（97.2%、73.5%和56.6%对95.3%、79.5%和70.6%，p = 0.727）或DFS率（59.4%、29.4%和22.9%对64.2%、33.1%和23.8%，p = 0.568）无显著差异。肝门周围位置不是LTP（p = 0.622）或OS（p = 0.587）的显著预后因素。此外，肝门周围组肝内胆管轻度扩张更常见（9.2%对2.8%，p = 0.045）。