Long-term results of liver thermal ablation in patients with hepatocellular carcinoma and colorectal cancer liver metastasis regarding spatial features and tumor-specific variables

IF 1.4 4区医学 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Diagnostic and interventional radiology Pub Date : 2024-05-13 Epub Date: 2023-03-20 DOI:10.4274/dir.2023.221986

Okan Akhan, Ahmet Gürkan Erdemir, Sevilay Karahan, Emre Ünal, Türkmen Turan Çiftçi, Devrim Akıncı, Şuayib Yalçın

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Abstract

Purpose: Colorectal cancer liver metastasis (CRLM) and hepatocellular carcinoma (HCC) are widely treated using microwave and radiofrequency ablation. Local tumor progression (LTP) may develop depending on the shortest vascular distance and large lesion diameter. This study aims to explore the effect of these spatial features and to investigate the correlation between tumor-specific variables and LTP.

Methods: This is a retrospective study covering the period between January 2007 and January 2019. One hundred twenty-five patients (CRLM: HCC: 64:61) with 262 lesions (CRLM: HCC: 142:120) were enrolled. The correlation between LTP and the variables was analyzed using the chi-square test, Fischer's exact test, or the Fisher-Freeman-Halton test where applicable. The local progression-free survival (Loc-PFS) was analyzed using the Kaplan-Meier method. Univariable and multivariable Cox regression analyses were performed to identify prognostic factors.

Results: Significant correlations were observed for LTP in both CRLM and HCC at a lesion diameter of 30-50 mm (P = 0.019 and P < 0.001, respectively) and SVD of ≤3 mm (P < 0.001 for both). No correlation was found between the ablation type and LTP (CRLM: P = 0.141; HCC: P = 0.771). There was no relationship between residue and the ablation type, but a strong correlation with tumor size was observed (P = 0.127 and P < 0.001, respectively). In CRLM, LTP was associated with mutant K-ras and concomitant lung metastasis (P < 0.001 and P = 0.003, respectively). In HCC, a similar correlation was found for Child-Pugh B, serum alpha-fetoprotein (AFP) level of >10 ng/mL, predisposing factors, and moderate histopathological differentiation (P < 0.001, P = 0.008, P = 0.027, and P < 0.001, respectively). In CRLM, SVD of ≤3 mm proved to be the variable with the greatest negative effect on Loc-PFS (P = 0.007), followed by concomitant lung metastasis (P = 0.027). In HCC, a serum AFP level of >10 ng/mL proved to be the variable with the greatest negative effect on Loc-PFS (P = 0.045).

Conclusion: In addition to the lesions' spatial features, tumor-specific variables may also have an impact on LTP.

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肝细胞癌和结肠直肠癌肝转移患者肝脏热消融的空间特征和肿瘤特异性变量的长期结果

目的：大肠癌肝转移（CRLM）和肝细胞癌（HCC）广泛采用微波和射频消融术进行治疗。局部肿瘤进展（LTP）可能取决于最短血管距离和大病灶直径。本研究旨在探讨这些空间特征的影响，并研究肿瘤特异性变量与 LTP 之间的相关性：这是一项回顾性研究，时间跨度为 2007 年 1 月至 2019 年 1 月。125名患者（CRLM：HCC：64:61）共262个病灶（CRLM：HCC：142:120）被纳入研究。LTP与变量之间的相关性采用卡方检验、Fischer精确检验或Fisher-Freeman-Halton检验（如适用）进行分析。局部无进展生存期（Loc-PFS）采用 Kaplan-Meier 法进行分析。为确定预后因素，进行了单变量和多变量考克斯回归分析：在病变直径为30-50毫米（P=0.019和P<0.001）和SVD≤3毫米（P<0.001）的CRLM和HCC中均观察到LTP的显著相关性。消融类型与 LTP 之间没有相关性（CRLM：P = 0.141；HCC：P = 0.771）。残留物与消融类型之间没有关系，但观察到与肿瘤大小有很强的相关性（分别为 P = 0.127 和 P <0.001）。在 CRLM 中，LTP 与突变 K-ras 和同时发生的肺转移有关（分别为 P < 0.001 和 P = 0.003）。在 HCC 中，Child-Pugh B、血清甲胎蛋白（AFP）水平大于 10 ng/mL、易感因素和中度组织病理学分化也存在类似的相关性（分别为 P <0.001、P =0.008、P = 0.027 和 P <0.001）。在CRLM中，SVD≤3毫米被证明是对Loc-PFS负面影响最大的变量（P = 0.007），其次是合并肺转移（P = 0.027）。在HCC患者中，血清AFP水平>10 ng/mL是对Loc-PFS负面影响最大的变量（P = 0.045）：结论：除了病变的空间特征外，肿瘤特异性变量也可能对LTP产生影响。

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

Diagnostic and interventional radiology Medicine-Radiology, Nuclear Medicine and Imaging

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4.80%

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期刊介绍： Diagnostic and Interventional Radiology (Diagn Interv Radiol) is the open access, online-only official publication of Turkish Society of Radiology. It is published bimonthly and the journal’s publication language is English. The journal is a medium for original articles, reviews, pictorial essays, technical notes related to all fields of diagnostic and interventional radiology.