经皮磁共振引导下热消融治疗复发性亚厘米级肝细胞癌
Percutaneous MR-Guided Thermal Ablation for Recurrent Subcentimeter Hepatocellular Carcinoma.
作者信息
Chen Jin, Zhang Bing, Yan Yuan, Wei Fu-Qun, Guo Rui, Huang Bing-Yu, Lv Bin, Lin Zheng-Yu
机构信息
Department of Interventional Radiology, the First Affiliated Hospital, Fujian Medical University, Fuzhou 350005, China (J.C., B.Z., Y.Y., F.-Q.W., R.G., B.-Y.H., Z.-Y.L.); Department of Interventional Radiology, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou 350212, China (J.C., Y.Y., F.-Q.W., R.G., B.-Y.H., Z.-Y.L.); Fujian Key Laboratory of Precision Medicine for Cancer, the First Affiliated Hospital, Fujian Medical University, Fuzhou 350005, China (J.C., Z.-Y.L.).
Department of Interventional Radiology, the First Affiliated Hospital, Fujian Medical University, Fuzhou 350005, China (J.C., B.Z., Y.Y., F.-Q.W., R.G., B.-Y.H., Z.-Y.L.).
出版信息
Acad Radiol. 2025 May 13. doi: 10.1016/j.acra.2025.04.053.
RATIONALE AND OBJECTIVES
To evaluate the technical efficacy and therapeutic outcomes of percutaneous MR-guided thermal ablation, including microwave ablation (MWA) and radiofrequency ablation (RFA) for recurrent subcentimeter hepatocellular carcinomas (HCCs). MATERIALS AND METHODS: From January 2015 to May 2024, we recruited 101 patients with 119 recurrent subcentimeter HCCs (mean diameter: 8.0±1.3 mm, range: 5.6-9.9mm), who were treated with MR-guided thermal ablation. Technical success, technical efficacy, complications, and local tumor progression (LTP) rate were evaluated after ablation. Cumulative LTP rate, recurrence-free survival (RFS), and overall survival (OS) rates were estimated using the Kaplan-Meier method.
RESULTS
A retrospective analysis showed that MR-guided thermal ablation (MWA, n=84; RFA, n=17) was successfully executed in all cases. Technical success and efficacy were achieved in all lesions in single sessions without major complications. The mean follow-up duration was 41.1±27.1 months (median:38.0 months; range:3-105 months). The cumulative LTP rate at 1 year was 1.2%, and 5.8% at 3, 5, 7, and 9 years. The cumulative RFS rates at 1, 3, 5, 7, and 9 years were 82.2%, 44.6%, 29.0%, 23.2%, and 23.2%, respectively. The cumulative OS rates at 1, 3, 5, 7, and 9 years were 99.0%, 91.8%, 84.4%, 69.7%, and 62.0%, respectively.
CONCLUSION
Percutaneous MR-guided thermal ablation for recurrent subcentimeter HCCs demonstrated ready visualization of lesions and ablation margins as well as high technical efficacy rate, and minimal LTP after a single treatment session.
原理与目的
评估经皮磁共振引导下热消融技术的疗效及治疗结果，包括微波消融（MWA）和射频消融（RFA）治疗复发性亚厘米级肝细胞癌（HCC）。材料与方法：2015年1月至2024年5月，我们招募了101例患有119个复发性亚厘米级HCC的患者（平均直径：8.0±1.3毫米，范围：5.6 - 9.9毫米），接受磁共振引导下热消融治疗。消融后评估技术成功率、技术疗效、并发症及局部肿瘤进展（LTP）率。采用Kaplan-Meier法估计累积LTP率、无复发生存率（RFS）和总生存率（OS）。结果：回顾性分析显示，所有病例均成功实施了磁共振引导下热消融（MWA，n = 84；RFA，n = 17）。单次治疗所有病灶均取得技术成功和疗效，无严重并发症。平均随访时间为41.1±27.1个月（中位数：38.0个月；范围：3 - 105个月）。1年时累积LTP率为1.2%，3、5、7和9年时为5.8%。1、3、5、7和9年时累积RFS率分别为82.2%、44.6%、29.0%、23.2%和23.2%。1、3、5、7和9年时累积OS率分别为99.0%、91.8%、84.4%、69.7%和62.0%。结论：经皮磁共振引导下热消融治疗复发性亚厘米级HCC显示出病灶及消融边缘易于可视化、技术有效率高，且单次治疗后LTP最小。
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