Percutaneous Microwave versus Radiofrequency Ablation of Colorectal Liver Metastases: Ablation with Clear Margins (A0) Provides the Best Local Tumor Control.
Percutaneous Microwave versus Radiofrequency Ablation of Colorectal Liver Metastases: Ablation with Clear Margins (A0) Provides the Best Local Tumor Control.
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DOI：
10.1016/j.jvir.2017.08.021
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发表时间：
2018-03
期刊：
影响因子：
--
通讯作者：
Sofocleous CT
中科院分区：
文献类型：
--
作者：
Shady W;Petre EN;Do KG;Gonen M;Yarmohammadi H;Brown KT;Kemeny NE;D'Angelica M;Kingham PT;Solomon SB;Sofocleous CT
确定并比较结直肠肝转移瘤（CLM）射频消融（RFA）和微波消融（MWA）后局部肿瘤无进展生存期（LTPFS）的预测因素。这是对2009年11月至2015年4月（110例患者）进行的CLM消融的回顾性综述。消融后6周，在对比增强CT上测量边缘。使用针对聚类调整的竞争风险模型评估LTPFS的临床和技术预测因素。RFA和MWA的技术有效性（完全消融）分别为93%（79/85）和97%（58/60）（P=0.47）。RFA组的中位随访时间明显长于MWA组（56个月vs 29个月）（P<0.001）。RFA和MWA之间的LTP率无差异（P=0.84）。在单变量分析中，射频消融的LTPFS较短的显著预测因素为消融边缘≤5 mm（P<0.001）（HR：14.6; 95% CI：5.2-40.9）和血管周围肿瘤（P=0.021）（HR：2.2; 95% CI：1.1-4.3）;在多变量分析中，两者均保持显著性。MWA单变量分析中LTPFS较短的显著预测因素为消融边缘≤5 mm（P<0.001）（SHR：11.6; 95% CI：3.1-42.7）和既往无肝切除史（P<0.013）（HR：3.2; 95%：1.3-7.8）;多变量分析中两者均保持显著性。切缘超过10 mm的消融肿瘤无LTP（中位LTPFS：未达到）。血管周围肿瘤不能预测MWA（P=0.43）。无论使用何种热消融方式，边缘>5 mm对于局部肿瘤控制至关重要，边缘超过10 mm时未观察到LTP。与RFA不同，MWA对血管周围肿瘤的效率不受影响。
To identify and compare predictors of local tumor progression free survival (LTPFS) after radiofrequency ablation (RFA) and microwave ablation (MWA) of colorectal liver metastases (CLM). This is a retrospective review of CLM ablated from November 2009 to April 2015 (110 patients). Margins were measured on contrast-enhanced CT 6 weeks post-ablation. Clinical and technical predictors of LTPFS were assessed using a competing risk model adjusted for clustering. Technique effectiveness (complete ablation) was 93% (79/85) for RFA and 97% (58/60) for MWA (P=0.47). The median follow-up period was significantly longer for RFA versus MWA (56 versus 29 months) (P<0.001). There was no difference in the LTP rates between RFA and MWA (P=0.84). Significant predictors of shorter LTPFS for RFA on univariate analysis were ablation margin ≤5 mm (P<0.001) (HR: 14.6; 95% CI: 5.2–40.9) and peri-vascular tumors (P=0.021) (HR: 2.2; 95% CI: 1.1–4.3); both retained significance on multivariate analysis. Significant predictors of shorter LTPFS on univariate analysis for MWA were ablation margin ≤5 mm (P<0.001) (SHR: 11.6; 95% CI: 3.1–42.7) and no history of prior liver resection (P<0.013) (HR: 3.2; 95%: 1.3–7.8); both retained significance on multivariate analysis. There was no LTP for tumors ablated with margin over 10 mm (median LTPFS: not reached). Peri-vascular tumors were not predictive for MWA (P=0.43). Regardless of the thermal ablation modality used, margins >5 mm are critical for local tumor control, with no LTP noted for margins over 10 mm. Unlike RFA, the efficiency of MWA was not affected for peri-vascular tumors.
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影响因子：
19.7
作者：
Livraghi, T;Solbiati, L;Goldberg, SN
通讯作者：
Goldberg, SN
影响因子：
19.7
作者：
Sotirchos, Vlasios S.;Petrovic, Lydia M.;Sofocleous, Constantinos T.
通讯作者：
Sofocleous, Constantinos T.
影响因子：
3.7
作者：
Elias, D;Baton, O;Lasser, P
通讯作者：
Lasser, P
影响因子：
--
作者：
Shady W;Petre EN;Vakiani E;Ziv E;Gonen M;Brown KT;Kemeny NE;Solomon SB;Solit DB;Sofocleous CT
通讯作者：
Sofocleous CT
DOI：
10.1097/meg.0b013e32835cb566
发表时间：
2013-04-01
影响因子：
2.1
作者：
Liu, Yingjun;Li, Shengping;Zheng, Yun
通讯作者：
Zheng, Yun