Safety margin of embolized area can reduce local recurrence of hepatocellular carcinoma after superselective transarterial chemoembolization
Safety margin of embolized area can reduce local recurrence of hepatocellular carcinoma after superselective transarterial chemoembolization
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DOI：
10.3350/cmh.2018.0072
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发表时间：
2019-03-01
影响因子：
8.9
通讯作者：
Piratvisuth, Teerha
中科院分区：
文献类型：
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作者：
Bannangkoon, Kittipitch;Hongsakul, Keerati;Piratvisuth, Teerha
背景/目标：方法：回顾性分析77例肝细胞癌（HCC）患者109个肝细胞癌结节行超选择性肝动脉化疗栓塞（TACE）治疗的临床资料，分析栓塞区域的安全范围与局部肿瘤复发（LTR）的关系。采用考克斯比例风险回归对16个潜在因素进行单变量和多变量分析。锥形束计算机断层扫描（CBCT）成像上的碘油沉积分为三级：A=肿瘤完全染色且周向安全边界完整，B=肿瘤完全染色但安全边界不完整，C=肿瘤染色不完整。结果：单因素和多因素分析显示，A级碘化油沉积和门静脉显影是影响LTR的仅有的两个独立显著因素（P< 0.001和P=0.029）。A级（n=62）、B级（n=30）和C级（n=17）肿瘤的12个月和24个月LTR率分别为16%、41%、100%和16%、61%、100%（P
Background/Aims: We aimed to determine the relationship between the safety margin of an embolized area and local tumor recurrence (LTR) of patients with hepatocellular carcinoma (HCC) who underwent superselective transarterial chemoembolization (TACE).Methods: The medical records of 77 HCC patients with 109 HCC nodules who underwent superselective TACE were retrospectively analyzed for LTR. Univariate and multivariate analyses were performed for 16 potential factors using Cox proportional hazard regression. Iodized oil deposition on cone-beam computed tomography (CBCT) imaging was divided into three grades: A=complete tumor staining and complete circumferential safety margin, B=complete tumor staining but incomplete safety margin, C=incomplete tumor staining. The effect of a safety margin on LTR was evaluated by comparison between grade A and B group.Results: Univariate and multivariate analyses revealed that grade A iodized oil deposition and portal vein visualization were the only two independent significant factors of LTR (P< 0.001 and P=0.029, respectively). The 12-and 24-month LTR rates of tumors for grade A (n=62), grade B (n=30), and grade C (n=17) were 16% vs. 41% vs. 100% and 16% vs. 61% vs. 100%, respectively (P