Hepatocellular carcinoma: Radio-frequency ablation of medium and large lesions
Hepatocellular carcinoma: Radio-frequency ablation of medium and large lesions
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DOI：
10.1148/radiology.214.3.r00mr02761
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发表时间：
2000-03-01
期刊：
影响因子：
19.7
通讯作者：
Gazelle, GS
中科院分区：
文献类型：
--
作者：
Livraghi, T;Goldberg, SN;Gazelle, GS
目的：探讨射频消融治疗肝硬变或慢性肝炎患者中大型肝细胞癌的局部疗效、不良反应及并发症。材料与方法：114例清醒镇静或全身麻醉的患者，用内冷电极射频治疗直径大于3 cm的12 6个肝癌。80例为中型(3.1~5.0 cm)，46例为大型(5.1~9.5 cm)。肿瘤平均直径5.4 cm。结果：肿瘤完全坏死60个(47.6%)，近全坏死40个(31.7%)，部分坏死(50%~89%)26个(20.6%)。中型和/或非浸润性肿瘤的治疗成功率明显高于大型和/或浸润性肿瘤。观察到两种主要并发症(死亡、出血需要剖腹手术)和五种轻微并发症(自限性出血、持续性疼痛)。结论：射频消融是一种有效、安全、相对简单的治疗中大型肝癌的方法。
PURPOSE: To study local therapeutic efficacy, side effects, and complications of radiofrequency (RF) ablation in the treatment of medium and large hepatocellular carcinoma (HCC) lesions in patients with cirrhosis or chronic hepatitis.MATERIALS AND METHODS: One-hundred fourteen patients who were under conscious sedation or general anesthesia had 126 HCCs greater than 3.0 cm in diameter treated with RF by using an internally cooled electrode. Eighty tumors were medium (3.1-5.0 cm), and 46 were large (5.1-9.5 cm). The mean diameter for all tumors was 5.4 cm. At imaging, 75 tumors were considered noninfiltrating, and 51 were considered infiltrating.RESULTS: Complete necrosis was attained in 60 lesions (47.6%), nearly complete (90%-99%) necrosis in 40 lesions (31.7%), and partial (50%-89%) necrosis in the remaining 26 lesions (20.6%). Medium and/or noninfiltrating tumors were treated successfully significantly more often than large and/or infiltrating tumors. Two major complications (death, hemorrhage requiring laparotomy) and five minor complications (self-limited hemorrhage, persistent pain) were observed. The single death was due to a break in sterile technique rather than to the RF procedure itself.CONCLUSION: RF ablation appears to be an effective, safe, and relatively simple procedure for the treatment of medium and large HCCs.