{"title":"经皮微波消融与硬化剂注射治疗大肝脏血管瘤:一项多中心队列研究。","authors":"Qian Cai, Tong-Gang Qian, Qi-Yu Zhao, Shun-You Feng, Qiao Yang, Yan-Chun Luo, Yu-Qing Dai, Ping Liang, Xiao-Ling Yu, Fang-Yi Liu, Zhi-Yu Han, Qiao-Wei Du, Xin Li, Jie Yu","doi":"10.1080/02656736.2023.2285705","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>The study aimed to compare the effectiveness and safety of ultrasound-guided microwave ablation (MWA) and percutaneous sclerotherapy (PS) for the treatment of large hepatic hemangioma (LHH).</p><p><strong>Methods: </strong>This retrospective study included 96 patients who underwent MWA (<i>n</i> = 54) and PS (<i>n</i> = 42) as first-line treatment for LHH in three tertiary hospitals from January 2016 to December 2021. Primary outcomes were technique efficacy rate (volume reduction rate [VRR] > 50% at 12 months), symptom relief rate at 12 months and local tumor progression (LTP). Secondary outcomes included procedure time, major complications, treatment sessions, cost and one-, two-, three-year VRR.</p><p><strong>Results: </strong>During a median follow-up of 36 months, the MWA group showed a higher technique efficacy rate (100% vs. 90.4%, <i>p</i> = .018) and symptom relief rate (100% vs. 80%, <i>p</i> = .123) than the PS group. The MWA group had fewer treatment sessions, higher one-, two- and three-year VRR, lower LTP rate (all <i>p</i> < .05), longer procedure time and higher treatment costs than the PS group (both <i>p</i> < .001). MWA shared a comparable major complications rate (1.8% vs. 2.4%, <i>p</i> = .432) with PS. After multivariate analysis, the lesion's heterogeneity and maximum diameter >8.1 cm were independent risk factors for LTP (all <i>p</i> < .05). In the PS group, lesions with a cumulative dose of bleomycin > 0.115 mg/cm<sup>3</sup> had a lower risk of LTP (<i>p</i> = .006).</p><p><strong>Conclusions: </strong>Both MWA and PS treatments for large hepatic hemangioma are safe and effective, with MWA being superior in terms of efficacy.</p>","PeriodicalId":14137,"journal":{"name":"International Journal of Hyperthermia","volume":null,"pages":null},"PeriodicalIF":3.0000,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Percutaneous microwave ablation versus sclerotherapy for large hepatic hemangioma: a multi-center cohort study.\",\"authors\":\"Qian Cai, Tong-Gang Qian, Qi-Yu Zhao, Shun-You Feng, Qiao Yang, Yan-Chun Luo, Yu-Qing Dai, Ping Liang, Xiao-Ling Yu, Fang-Yi Liu, Zhi-Yu Han, Qiao-Wei Du, Xin Li, Jie Yu\",\"doi\":\"10.1080/02656736.2023.2285705\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>The study aimed to compare the effectiveness and safety of ultrasound-guided microwave ablation (MWA) and percutaneous sclerotherapy (PS) for the treatment of large hepatic hemangioma (LHH).</p><p><strong>Methods: </strong>This retrospective study included 96 patients who underwent MWA (<i>n</i> = 54) and PS (<i>n</i> = 42) as first-line treatment for LHH in three tertiary hospitals from January 2016 to December 2021. Primary outcomes were technique efficacy rate (volume reduction rate [VRR] > 50% at 12 months), symptom relief rate at 12 months and local tumor progression (LTP). Secondary outcomes included procedure time, major complications, treatment sessions, cost and one-, two-, three-year VRR.</p><p><strong>Results: </strong>During a median follow-up of 36 months, the MWA group showed a higher technique efficacy rate (100% vs. 90.4%, <i>p</i> = .018) and symptom relief rate (100% vs. 80%, <i>p</i> = .123) than the PS group. The MWA group had fewer treatment sessions, higher one-, two- and three-year VRR, lower LTP rate (all <i>p</i> < .05), longer procedure time and higher treatment costs than the PS group (both <i>p</i> < .001). MWA shared a comparable major complications rate (1.8% vs. 2.4%, <i>p</i> = .432) with PS. After multivariate analysis, the lesion's heterogeneity and maximum diameter >8.1 cm were independent risk factors for LTP (all <i>p</i> < .05). In the PS group, lesions with a cumulative dose of bleomycin > 0.115 mg/cm<sup>3</sup> had a lower risk of LTP (<i>p</i> = .006).</p><p><strong>Conclusions: </strong>Both MWA and PS treatments for large hepatic hemangioma are safe and effective, with MWA being superior in terms of efficacy.</p>\",\"PeriodicalId\":14137,\"journal\":{\"name\":\"International Journal of Hyperthermia\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":3.0000,\"publicationDate\":\"2024-01-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"International Journal of Hyperthermia\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1080/02656736.2023.2285705\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/1/25 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q2\",\"JCRName\":\"ONCOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Journal of Hyperthermia","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1080/02656736.2023.2285705","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/1/25 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"ONCOLOGY","Score":null,"Total":0}
Percutaneous microwave ablation versus sclerotherapy for large hepatic hemangioma: a multi-center cohort study.
Objective: The study aimed to compare the effectiveness and safety of ultrasound-guided microwave ablation (MWA) and percutaneous sclerotherapy (PS) for the treatment of large hepatic hemangioma (LHH).
Methods: This retrospective study included 96 patients who underwent MWA (n = 54) and PS (n = 42) as first-line treatment for LHH in three tertiary hospitals from January 2016 to December 2021. Primary outcomes were technique efficacy rate (volume reduction rate [VRR] > 50% at 12 months), symptom relief rate at 12 months and local tumor progression (LTP). Secondary outcomes included procedure time, major complications, treatment sessions, cost and one-, two-, three-year VRR.
Results: During a median follow-up of 36 months, the MWA group showed a higher technique efficacy rate (100% vs. 90.4%, p = .018) and symptom relief rate (100% vs. 80%, p = .123) than the PS group. The MWA group had fewer treatment sessions, higher one-, two- and three-year VRR, lower LTP rate (all p < .05), longer procedure time and higher treatment costs than the PS group (both p < .001). MWA shared a comparable major complications rate (1.8% vs. 2.4%, p = .432) with PS. After multivariate analysis, the lesion's heterogeneity and maximum diameter >8.1 cm were independent risk factors for LTP (all p < .05). In the PS group, lesions with a cumulative dose of bleomycin > 0.115 mg/cm3 had a lower risk of LTP (p = .006).
Conclusions: Both MWA and PS treatments for large hepatic hemangioma are safe and effective, with MWA being superior in terms of efficacy.