Long-term survival analysis of ultrasound-guided percutaneous microwave ablation for hepatocellular carcinoma conforming to the Milan criteria: primary versus recurrent HCC.

IF 3 3区 医学 Q2 ONCOLOGY
International Journal of Hyperthermia Pub Date : 2024-01-01 Epub Date: 2024-03-11 DOI:10.1080/02656736.2024.2318829
Jing Zhang, Guanya Guo, Tao Li, Changcun Guo, Ying Han, Xinmin Zhou
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Abstract

Background: This study compared long-term outcomes between patients with initial hepatocellular carcinoma (IHCC) and those with recurrent HCC (RHCC) treated with microwave ablation (MWA).

Methods: This retrospective study included 425 patients with HCCs (294 IHCCs and 131 RHCCs) within the Milan criteria who were treated with ultrasound-guided percutaneous MWA between January 2008 and November 2021. All patients with RHCC had previously undergone MWA for initial HCC. Overall survival (OS) and recurrence-free survival (RFS) rates were compared between the IHCC and RHCC groups before and after propensity score matching (PSM).

Results: Before matching, the 1-, 3-, 5-, and 10-year OS rates in the IHCC group were 95.9%, 78.5%, 60.2%, and 42.5%, respectively, which were significantly higher than those in the RHCC group (93.8%, 70.0%, 42.0%, and 6.6%, respectively). This difference remained significant after PSM. However, subgroup analyses suggested that there were no significant differences in OS rates between IHCC and RHCC in patients with solitary HCC ≤3.0 cm, AFP ≤200 ng/mL, ablative margins ≥0.5 cm, or Albumin-Bilirubin (ALBI) grade 1. RFS was significantly higher in IHCC than in RHCC before and after PSM, as well as in subgroup analyses. ALBI grade (hazard ratio (HR), 2.38; 95% CI: 1.46-3.86; p < 0.001), serum AFP level (HR, 2.07; 95% CI: 1.19-3.62; p = 0.010) and ablative margins (HR, 0.18; 95% CI: 0.06-0.59; p = 0.005) were independent prognostic factors for OS of RHCC. Serum AFP(HR, 1.29; 95% CI: 1.02-1.63, p = 0.036) level was the only factor associated with RFS in RHCC.

Conclusions: MWA yielded comparable OS in IHCC and RHCC patients with solitary HCC ≤3.0 cm, AFP ≤200 ng/mL, ablative margins ≥0.5 cm, or ALBI grade 1.

超声引导下经皮微波消融治疗符合米兰标准的肝细胞癌的长期生存分析:原发性与复发性肝细胞癌。
背景:本研究比较了初诊肝细胞癌(IHCC)患者和接受微波消融术(MWA)治疗的复发性肝细胞癌(RHCC)患者的长期疗效:这项研究比较了初发肝细胞癌(IHCC)患者和接受微波消融术(MWA)治疗的复发性肝细胞癌(RHCC)患者的长期疗效:这项回顾性研究纳入了2008年1月至2021年11月期间接受超声引导经皮微波消融术治疗的425例符合米兰标准的HCC患者(294例IHCC和131例RHCC)。所有RHCC患者都曾因初次HCC而接受过MWA治疗。比较了倾向评分匹配(PSM)前后IHCC组和RHCC组的总生存率(OS)和无复发生存率(RFS):匹配前,IHCC 组的 1 年、3 年、5 年和 10 年 OS 率分别为 95.9%、78.5%、60.2% 和 42.5%,显著高于 RHCC 组(分别为 93.8%、70.0%、42.0% 和 6.6%)。PSM 后,这一差异仍然明显。然而,亚组分析表明,在单发HCC≤3.0厘米、AFP≤200纳克/毫升、消融边缘≥0.5厘米或白蛋白-胆红素(ALBI)1级的患者中,IHCC和RHCC的OS率没有明显差异。在PSM前后以及亚组分析中,IHCC的RFS明显高于RHCC。ALBI分级(危险比(HR),2.38;95% CI:1.46-3.86;P = 0.010)和消融边缘(HR,0.18;95% CI:0.06-0.59;P = 0.005)是影响RHCC OS的独立预后因素。血清甲胎蛋白(HR,1.29;95% CI:1.02-1.63,p = 0.036)水平是唯一与RHCC的RFS相关的因素:在单发HCC≤3.0 cm、AFP≤200 ng/mL、消融边缘≥0.5 cm或ALBI 1级的IHCC和RHCC患者中,MWA的OS相当。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
5.90
自引率
12.90%
发文量
153
审稿时长
6-12 weeks
期刊介绍: The International Journal of Hyperthermia
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