摘要
Background:No reports are available on the technical efficiency and therapeutic response of virtual navigation(VN)-guided radiofrequency ablation(RFA)for patients with recurrent hepatocellular carcinoma(HCC)after hepatic resection.The aim of this study was to investigate the overall technical performance and outcome of VN-guided RFA in recurrent HCC patients.In addition,a nomogram model was developed to predict the factors influencing the overall survival(OS).Methods:This was a prospective study on 76 recurrent HCC patients who underwent VN-guided RFA between June 2015 and February 2018.The technical feasibility,success,and efficiency,OS,local tumor progression,and complications were evaluated.A multivariate Cox regression analysis was conducted to predict the significant factors,and a nomogram including independent predictive factors was subsequently plotted to predict OS.Results:The technical feasibility,success,and efficiency rates of VN-guided RFA were 86.4%,94.7%,and 97.4%,respectively.The cumulative OS rates at 1-,2-,and 3-year were 88.1%,79.7%,and 71.0%,respectively.The cumulative local tumor progression rates at 1-,2-,and 3-year were 5.5%,8.7%,and 14.0%,respectively.In addition,the minor and major complication rates were 5.3%and 3.9%,respectively.No intervention-related deaths occurred during the follow-up period.The C-index of the OS nomogram in this study was 0.737.Conclusions:VN-guided RFA is an effective therapeutic option in recurrent HCC patients and improves the long-term outcomes especially for the lesions that cannot be detected in the two-dimensional ultrasound.Besides,the nomogram may be a useful supporting tool in predicting OS to estimate the individual survival probability,optimize treatment options,and facilitate decision-making.
基金
the National S&T Major Project of China(2017ZX10203205)
the State Major Research Program of China(2018 YFC0114900)
the National Natural Science Foundation of China(81971623)
the Major Research Project of the National Natural Science Foundation of China(91630311)
the Natural Science Foundation of Zhejiang Province(SZ20 H180002)
the Zhejiang Society Joint Foundation for Mathematical Medicine(LSY19 H180015).