|Radiofrequency ablation of hepatocellular carcinoma in difficult locations: Strategies and long-term outcomes|
|Yang, Wei1; Yan, Kun1; Wu, Gong-Xiong2,3; Wu, Wei1; Fu, Ying1; Lee, Jung-Chieh1; Zhang, Zhong-Yi1; Wang, Song1; Chen, Min-Hua1|
|关键词||Radiofrequency ablation Ultrasound guidance Hepatocellular carcinoma Difficult location Long-term outcome|
|刊名||WORLD JOURNAL OF GASTROENTEROLOGY|
|WOS标题词||Science & Technology|
|类目[WOS]||Gastroenterology & Hepatology|
|研究领域[WOS]||Gastroenterology & Hepatology|
|关键词[WOS]||PERCUTANEOUS ETHANOL INJECTION ; PROGNOSTIC-FACTORS ; LIVER-TUMORS ; THERMAL ABLATION ; HEPATIC-TUMORS ; COMPLICATIONS ; RESECTION ; EFFICACY ; SAFETY ; METAANALYSIS|
AIM: To investigate the treatment strategies and long-term outcomes of radiofrequency ablation (RFA) of hepatocellular carcinoma (HCC) in difficult locations and to compare the results with non-difficult HCC.
METHODS: From 2004 to 2012, a total of 470 HCC patients underwent ultrasound-guided percutaneous RFA. Among these HCC patients, 382 with tumors located <= 5 mm from a major vessel/bile duct (n = 87), from peripheral important structures (n = 232) or from the liver capsule (n = 63) were regarded as difficult cases. There were 331 male patients and 51 female patients, with an average age of 55.3 +/- 10.1 years old. A total of 235 and 147 patients had Child-Pugh class A and class B liver function, respectively. The average tumor size was 3.4 +/- 1.2 cm. Individual treatment strategies were developed to treat these difficult cases. During the same period, 88 HCC patients with tumors that were not in difficult locations served as the control group. In the control group, 74 patients were male, and 14 patients were female, with an average age of 57.4 +/- 11.8 years old. Of these, 62 patients and 26 patients had Child-Pugh class A and class B liver function, respectively. Regular follow-up after RFA was performed to assess treatment efficacy. Survival results were generated from Kaplan-Meier estimates, and multivariate analysis was performed using the Cox regression model.
RESULTS: Early tumor necrosis rate in the difficult group was similar to that in the control group (97.6% vs 94.3%, P = 0.080). The complication rate in the difficult group was significantly higher than that in the control group (4.9% vs 0.8%, P = 0.041). The follow-up period ranged from 6 to 116 mo, with an average of 28 +/- 22.4 mo. Local progression rate in the difficult group was significantly higher than that in the control group (12.7% vs 7.1%, P = 0.046). However, the 1-, 3-, 5-, and 7- year overall survival rates in the difficult group were not significantly different from those in the control group (84.3%, 54.4%, 41.2%, and 29.9% vs 92.5%, 60.3%, 43.2%, and 32.8%, respectively, P = 0.371). Additionally, a multivariate analysis revealed that tumor location was not a significant risk factor for survival.
CONCLUSION: There was no significant difference in long-term overall survival between the two groups even though the local progression rate was higher in the difficult group.
|项目编号||81101745 ; 2013-3-086 ; Z111107067311026|
|资助机构||National Natural Science Foundation of China ; Beijing Municipal Health System Special Funds of High-Level Medical Personnel Construction, ; Training Program of the Health Research Plan of the Capital Citizens|
|作者单位||1.Peking Univ Canc Hosp & Inst, Minist Educ, Dept Ultrasound, Key Lab Carcinogenesis & Translat Res, Beijing 100142, Peoples R China|
2.Harvard Univ, Sch Med, Joslin Diabet Ctr, Div Res, Boston, MA 02215 USA
3.Guangzhou Med Univ, Guangzhou Inst Cardiovasc Dis, Hosp Affiliated 2, Dept Cardiovasc, Guangzhou 510182, Guangdong, Peoples R China
|Yang, Wei,Yan, Kun,Wu, Gong-Xiong,et al. Radiofrequency ablation of hepatocellular carcinoma in difficult locations: Strategies and long-term outcomes[J]. WORLD JOURNAL OF GASTROENTEROLOGY,2015,21(5):1554-1566.|
|APA||Yang, Wei.,Yan, Kun.,Wu, Gong-Xiong.,Wu, Wei.,Fu, Ying.,...&Chen, Min-Hua.(2015).Radiofrequency ablation of hepatocellular carcinoma in difficult locations: Strategies and long-term outcomes.WORLD JOURNAL OF GASTROENTEROLOGY,21(5),1554-1566.|
|MLA||Yang, Wei,et al."Radiofrequency ablation of hepatocellular carcinoma in difficult locations: Strategies and long-term outcomes".WORLD JOURNAL OF GASTROENTEROLOGY 21.5(2015):1554-1566.|