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经皮微波消融治疗危险部位肝癌的安全性和疗效分析 被引量:29

Safety and efficacy of microwave ablation for hepatocellular carcinoma at dangerous locations
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摘要 目的探讨超声引导经皮微波消融(MWA)治疗危险部位原发性肝癌(HCC)的疗效和安全性。方法回顾性分析375例接受超声引导下MWA治疗的HCC患者资料。根据肿瘤位置,分为危险组(肿瘤距重要器官或组织≤5mm)及非危险组(肿瘤距重要器官或组织>5mm)。比较两组的疗效及严重并发症发生率。结果危险组196例共258个病灶,非危险组179例共233个病灶。两组完全消融率分别为97.67%(252/258)、97.85%(228/233),差异无统计学意义(P=0.61)。危险组和非危险组患者1、3、5年局部肿瘤进展率分别为9.57%、19.72%、24.18%和7.34%、13.44%、14.61%;无瘤生存率分别为68.88%、36.22%、25.37%和73.74%、43.17%、19.12%;累积生存率分别为90.87%、69.50%、60.05%和94.97%、74.24%、64.91%。两组间1、3、5年局部肿瘤进展率、无瘤生存率、累积生存率差异均无统计学意义(P=0.11、0.19、0.17)。危险组和非危险组严重并发症发生率分别为3.06%(9/196)和1.11%(2/179),差异无统计学意义(P=0.35)。结论通过采用适当的辅助治疗方法,超声引导下MWA治疗危险部位HCC可获得与非危险部位肿瘤相当的局部和远期疗效。 Objective To analyze the safety and efficacy of ultrasound-guided microwave ablation (MWA) for patients with primary hepatocellular carcinoma (HCC) at dangerous locations. Methods Data of 375 patients with HCC underwent MWA were retrospectively analyzed. According to the location of tumors, the patients were classified into dangerous group (distance from vital tissues to lesions ≤5 mm) and non-dangerous group (distance from vital tissues to lesions 〉5 mm). The efficacy of MWA and the incidence of serious complications of the two groups were compared. Results There were 196 patients with 258 lesions in dangerous group and 179 patients with 233 lesions in non-dangerous group. No statistical differences of the completed ablation rate was found between dangerous group (97.67% [252/258]) and non-dangerous group (97.85% [228/233], P=0.61). The 1-, 3-, 5-year local tumor progression (LTP) rates were 9.57%, 19.72%, 24.18% in dangerous group and 7.34%, 13.44%, 14.61% in non-dangerous group. The 1-, 3-, 5-year progression free survival (PFS) rates were 68.88%, 36.22%, 25.37% in dangerous group and 73.74%, 43.17%, 19.12% in non-dangerous group. The 1-, 3-, 5-year overall survival (OS) rates in dangerous group and non-dangerous group were 90.87%, 69.50%, 60.05% and 94.97%, 74.24%, 64.91%, respectively. No statistically significant differences of the 1-, 3-, 5-year LTP, OS and PFS rates were found between the two groups (P=0.11, 0.19, 0.17). The serious complications rates were 3.06% (9/196) and 1.11% (2/179) in dangerous group and non-dangerous group, respectively, which had no statistically significant difference between the two groups (P=0.35). Conclusion Ultrasound-guided percutaneous MWA is safe and effective for patients with HCC at dangerous locations. The adjuvant methods can help MWA to gain the similar local and long-term outcomes for patients with HCC at dangerous locations to those at non-dangerous locations.
出处 《中国介入影像与治疗学》 CSCD 北大核心 2017年第4期205-209,共5页 Chinese Journal of Interventional Imaging and Therapy
关键词 肝细胞 微波消融 危险部位 治疗结果 并发症 Carcinoma, hepatocellular Microwave ablation Dangerous locations Treatment outcome Complications
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