Percutaneous radio-frequency thermal ablation of nonresectable hepatocellular carcinoma after occlusion of tumor blood supply
Percutaneous radio-frequency thermal ablation of nonresectable hepatocellular carcinoma after occlusion of tumor blood supply
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DOI：
10.1148/radiology.217.1.r00se02119
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发表时间：
2000-10-01
期刊：
影响因子：
19.7
通讯作者：
Bartolozzi, C
中科院分区：
文献类型：
--
作者：
Rossi, S;Garbagnati, F;Bartolozzi, C
目得：评价经皮射频（RF）热消融治疗肿瘤供血动脉阻断后不能切除的肝细胞癌（HCC）的有效性。材料和方法：62例肝硬化和活检证实的HCC患者在用球囊导管阻断肝动脉阻断肿瘤动脉供应后接受了射频消融（40例患者）或明胶海绵颗粒供血动脉结果：在56名患者接受单次射频手术后和6名患者接受两次手术后，螺旋计算机断层扫描（CT）显示了一个与先前确定的HCC形状相对应的非增强区，这表明是完全坏死无严重并发症发生。2例患者随后接受了手术切除;其余60例患者进行了螺旋CT随访。在平均12.1个月的随访中，11个HCC结节显示局部进展区域; 49个被确定为非增强区域，最大直径减小40%-75%。局部复发的1年失败风险估计值为19%，总体肝内复发为45%。估计1年生存率为87%。一个尸检和两个手术标本的组织学分析显示超过90%的坏死，在一个标本和100%的坏死，在两个。结论：直径3.5-8.5 cm的肝癌结节可以消融在一个或两个射频治疗后，阻断肿瘤动脉供应。
PURPOSE: To evaluate the usefulness of percutaneous radio-frequency (RF) thermal ablation of nonresectable hepatocellular carcinoma (HCC) after occlusion of the tumor arterial supply.MATERIALS AND METHODS: Sixty-two patients with cirrhosis and biopsy-proved HCC underwent RF ablation after interruption of the tumor arterial supply by means of occlusion of either the hepatic artery with a balloon catheter (40 patients) or the feeding arteries with gelatin sponge particles (22 patients).RESULTS: After a single RF procedure in 56 patients and after two procedures in six patients, spiral computed tomography (CT) demonstrated a nonenhancing area corresponding in shape to the previously identified HCC, which was suggestive of complete necrosis. No major complications occurred. Two patients subsequently underwent surgical resection; the remaining 60 patients were followed up with spiral CT. During a mean follow-up of 12.1 months, 11 HCC nodules showed areas of local progression; 49 were identified as nonenhancing areas with a 40%-75% reduction in maximum diameter. The 1-year estimate of failure risk was 19% for local recurrence and 45% for overall intrahepatic recurrence. The estimated 1-year survival was 87%. Histopathologic analysis of one autopsy and two surgical specimens revealed more than 90% necrosis in one specimen and 100% necrosis in two.CONCLUSION: HCC nodules 3.5-8.5 cm in diameter can be ablated in one or two RF sessions after occlusion of the tumor arterial supply.