Sun Jia-Peng, Zhou Kang, Pan Jie, Yang Ning, Sun Xiao-Nan, Zhao Hai-Tao, Yang Xiao-Bo
Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China.
Department of Liver Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China.
World J Gastroenterol. 2025 Jul 28;31(28):109078. doi: 10.3748/wjg.v31.i28.109078.
Hepatic hemangiomas represent the most prevalent benign liver tumors. Surgical management of large symptomatic hepatic hemangiomas remains controversial and there is an increasing interest in minimally invasive techniques, such as transcatheter arterial chemoembolization (TACE) and microwave ablation (MWA).
To evaluate the efficacy and safety of TACE combined with MWA for large hepatic hemangiomas.
This retrospective cohort study was conducted at Peking Union Medical College Hospital between January 2015 and January 2024. Eighty-two patients with hepatic hemangiomas > 5 cm were divided into two groups: Observation (TACE + MWA, = 50) and control (TACE, = 32). Tumor diameter and treatment outcomes were evaluated at baseline, 12 months, and > 3 years. Appropriate statistical tests were chosen based on the type and distribution of the data.
At baseline, the median tumor diameter was 8.3 (range: 5.0-19.2) cm in the observation group and 8.5 (range: 5.0-20.0) cm in the control group. The median follow-up duration was 44.6 (95% confidence interval: 36.7-52.5) months. At 12 months post-treatment, the observation group demonstrated a higher tumor reduction ratio compared to the control group (50.98% 23.28%, respectively; < 0.001). The objective response rate was 93.94% in the observation group, which was significantly higher than that in the control group (33.33%) ( < 0.001). No recurrence occurred in the observation group, while one case occurred in the control group. Notably, no cases of hemoglobinuria or acute kidney injury were reported in the observation group.
Combination treatment enhances tumor shrinkage, promotes long-term tumor control, and reduces the complications associated with MWA, thereby presenting a promising alternative to surgical resection.
肝血管瘤是最常见的肝脏良性肿瘤。大型有症状肝血管瘤的手术治疗仍存在争议，人们对微创技术的兴趣与日俱增，如经导管动脉化疗栓塞术（TACE）和微波消融术（MWA）。
评估TACE联合MWA治疗大型肝血管瘤的疗效和安全性。
本回顾性队列研究于2015年1月至2024年1月在北京协和医院进行。82例肝血管瘤直径>5 cm的患者分为两组：观察组（TACE+MWA，n=50）和对照组（TACE，n=32）。在基线、12个月和>3年时评估肿瘤直径和治疗效果。根据数据的类型和分布选择适当的统计检验方法。
基线时，观察组的中位肿瘤直径为8.3（范围：5.0-19.2）cm，对照组为8.5（范围：5.0-20.0）cm。中位随访时间为44.6（95%置信区间：36.7-52.5）个月。治疗后12个月，观察组的肿瘤缩小率高于对照组（分别为50.98%和23.28%；P<0.001）。观察组的客观缓解率为93.94%，显著高于对照组（33.33%）（P<0.001）。观察组无复发，而对照组有1例复发。值得注意的是，观察组未报告血红蛋白尿或急性肾损伤病例。
联合治疗可增强肿瘤缩小，促进长期肿瘤控制，并减少与MWA相关的并发症，从而为手术切除提供了一种有前景的替代方案。
