Percutaneous ultrasound-guided thermal ablation for intrahepatic cholangiocarcinoma.
Percutaneous ultrasound-guided thermal ablation for intrahepatic cholangiocarcinoma.
复制标题
DOI：
10.1259/bjr/24563774
复制
发表时间：
2011-07
期刊：
影响因子：
--
通讯作者：
H-X Xu;Yidan Wang;M. Lu;L-N Liu
中科院分区：
文献类型：
--
作者：
H-X Xu;Yidan Wang;M. Lu;L-N Liu
目的评价超声引导下经皮肝内胆管癌（ICC）微波消融和射频消融治疗的疗效和总生存期。方法对18例25个ICC结节进行超声引导下热消融治疗。8例为原发病例，10例为根治性切除后复发病例。分析局部治疗反应、并发症和生存率。结果23个（92.0%，23/25）结节（直径0.7- 4.3cm，平均2.5 ± 0.9cm）完全消融，2个（8.0%，2/25）较大肿瘤（直径6.4和6.9cm）不完全消融。无手术死亡，主要并发症发生率为5.5%（1/18）。随访时间范围为1.3至86.2个月（平均20.5 ± 26.3个月;中位数8.7个月）。所有患者在6、12、36和60个月时的OS率分别为66.7%、36.3%、30.3%和30.3%。通过单变量分析，发现患者来源（原发或复发病例）是OS率的重要预后因素（p=0.001）。患者来源（p=0.001）和结节数量（p=0.038）被认为是无复发生存的重要预后因素。原发性ICC在6、12、36和60个月的OS率分别为87.5%、75.0%、62.5%和62.5%。结论超声引导下经皮热消融治疗ICC是一种安全有效的治疗方法。原发性ICC可以获得可接受的生存率，而复发性ICC的预后相对较差。
OBJECTIVE The objective of this study was to evaluate the treatment efficacy and overall survival (OS) of percutaneous ultrasound-guided thermal ablation by means of microwave ablation or radiofrequency ablation for intrahepatic cholangiocarcinoma (ICC). METHODS 18 patients with 25 ICC nodules underwent ultrasound-guided thermal ablation with curative intention. 8 patients were primary cases and 10 were recurrent cases after curative resection. The local treatment response, complications and survivals were analysed. RESULTS Complete ablation was achieved in 23 (92.0%, 23/25) nodules (diameter, 0.7-4.3 cm; mean, 2.5 ± 0.9 cm) and incomplete ablation was found in 2 (8.0%, 2/25) larger tumours (6.4 and 6.9 cm in diameter). No death associated with the treatment was found. The major complication rate was 5.5% (1/18). The follow-up periods ranged from 1.3 to 86.2 months (mean, 20.5 ± 26.3 months; median, 8.7 months). OS rates for all patients at 6, 12, 36 and 60 months were 66.7%, 36.3%, 30.3% and 30.3%, respectively. By univariate analysis, the patient source (primary or recurrent case) was found to be a significant prognostic factor for OS rates (p=0.001). The patient source (p=0.001) and the number of nodules (p=0.038) were found to be significant prognostic factors for recurrence-free survival. OS rates for the primary ICC at 6, 12, 36 and 60 months were 87.5%, 75.0%, 62.5% and 62.5%, respectively. CONCLUSION Percutaneous ultrasound-guided thermal ablation is a safe and effective therapeutic technique for ICC. Acceptable survival can be achieved in primary ICCs, whereas the prognosis of recurrent ICCs is relatively poor.