Yunhua Tan, Xin Wang, Kuansheng Ma, Lin Zhang, Jing Li, Ping Chen, Ben Zhang
{"title":"多电极转换系统经皮射频消融治疗早期肝癌复发的危险因素:一项多中心前瞻性研究。","authors":"Yunhua Tan, Xin Wang, Kuansheng Ma, Lin Zhang, Jing Li, Ping Chen, Ben Zhang","doi":"10.1080/02656736.2021.2024279","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the long-term efficacy of radiofrequency ablation (RFA) with a multiple-electrode switching system (MESS) in the treatment of early hepatocellular carcinoma (HCC) and evaluate the patterns and risk factors of intrahepatic recurrence of HCC after RFA.</p><p><strong>Methods: </strong>In total, 139 patients with early HCC who underwent RFA with MESS as primary treatment at multiple centers were prospectively enrolled according to the inclusion criteria. We evaluated the local tumor progression (LTP), intrahepatic distant recurrence (IDR), the incidence of cumulative disease-free survival (DFS), LTP-free survival, IDR-free survival, and overall survival. We also analyzed the associated risk factors.</p><p><strong>Results: </strong>A total of 139 patients were included in the study and the median follow-up time was 64 months, ranging from 11 to 72 months. The complete ablation rate was 98.56%. Sixty-nine (49.64%) were found to have intrahepatic recurrence (LTP, <i>n</i> = 15; IDR, <i>n</i> = 55) during follow-up. The 1-year, 3-year and 5-year cumulative DFS, LTP-free survival, and IDR-free survival rates were 74.82, 94.46 and 78.75%; 54.68, 88.03 and 61.79%; and 51.80, 85.67 and 60.17%, respectively. In the multivariable analysis, tumor size > 4 cm was the only important risk factor for LTP. The alkaline phosphatase (ALP) level and the number of tumors were independent risk factors for IDR; α-fetoprotein (AFP) level > 400 µg/L and recurrence interval were risk factors for the overall survival period.</p><p><strong>Conclusions: </strong>The MESS-RFA is an effective method for local control of tumors in early HCC. Early HCC with multiple high-ALP tumors has a higher rate of recurrence, which mainly occurs in an IDR pattern. Early HCC with high AFP levels and a shorter initial recurrence interval resulted in a poorer prognosis. Thus, treatments such as liver transplantation or surgical resection may be a good strategy in those cases.</p><p><strong>Clinicaltrials.gov id: </strong>NCT02046356.</p>","PeriodicalId":520653,"journal":{"name":"International journal of hyperthermia : the official journal of European Society for Hyperthermic Oncology, North American Hyperthermia Group","volume":" ","pages":"190-199"},"PeriodicalIF":3.0000,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"5","resultStr":"{\"title\":\"Risk factors for the recurrence of early hepatocellular carcinoma treated by percutaneous radiofrequency ablation with a multiple-electrode switching system: a multicenter prospective study.\",\"authors\":\"Yunhua Tan, Xin Wang, Kuansheng Ma, Lin Zhang, Jing Li, Ping Chen, Ben Zhang\",\"doi\":\"10.1080/02656736.2021.2024279\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>To investigate the long-term efficacy of radiofrequency ablation (RFA) with a multiple-electrode switching system (MESS) in the treatment of early hepatocellular carcinoma (HCC) and evaluate the patterns and risk factors of intrahepatic recurrence of HCC after RFA.</p><p><strong>Methods: </strong>In total, 139 patients with early HCC who underwent RFA with MESS as primary treatment at multiple centers were prospectively enrolled according to the inclusion criteria. We evaluated the local tumor progression (LTP), intrahepatic distant recurrence (IDR), the incidence of cumulative disease-free survival (DFS), LTP-free survival, IDR-free survival, and overall survival. We also analyzed the associated risk factors.</p><p><strong>Results: </strong>A total of 139 patients were included in the study and the median follow-up time was 64 months, ranging from 11 to 72 months. The complete ablation rate was 98.56%. Sixty-nine (49.64%) were found to have intrahepatic recurrence (LTP, <i>n</i> = 15; IDR, <i>n</i> = 55) during follow-up. The 1-year, 3-year and 5-year cumulative DFS, LTP-free survival, and IDR-free survival rates were 74.82, 94.46 and 78.75%; 54.68, 88.03 and 61.79%; and 51.80, 85.67 and 60.17%, respectively. In the multivariable analysis, tumor size > 4 cm was the only important risk factor for LTP. The alkaline phosphatase (ALP) level and the number of tumors were independent risk factors for IDR; α-fetoprotein (AFP) level > 400 µg/L and recurrence interval were risk factors for the overall survival period.</p><p><strong>Conclusions: </strong>The MESS-RFA is an effective method for local control of tumors in early HCC. Early HCC with multiple high-ALP tumors has a higher rate of recurrence, which mainly occurs in an IDR pattern. Early HCC with high AFP levels and a shorter initial recurrence interval resulted in a poorer prognosis. Thus, treatments such as liver transplantation or surgical resection may be a good strategy in those cases.</p><p><strong>Clinicaltrials.gov id: </strong>NCT02046356.</p>\",\"PeriodicalId\":520653,\"journal\":{\"name\":\"International journal of hyperthermia : the official journal of European Society for Hyperthermic Oncology, North American Hyperthermia Group\",\"volume\":\" \",\"pages\":\"190-199\"},\"PeriodicalIF\":3.0000,\"publicationDate\":\"2022-01-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"5\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"International journal of hyperthermia : the official journal of European Society for Hyperthermic Oncology, North American Hyperthermia Group\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1080/02656736.2021.2024279\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"International journal of hyperthermia : the official journal of European Society for Hyperthermic Oncology, North American Hyperthermia Group","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1080/02656736.2021.2024279","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 5
摘要
目的:探讨多电极切换系统(MESS)射频消融(RFA)治疗早期肝细胞癌(HCC)的远期疗效，探讨射频消融后肝内肝癌复发的模式及危险因素。方法:根据纳入标准，共纳入139例早期HCC患者，这些患者在多个中心接受RFA并以MESS为主要治疗。我们评估了局部肿瘤进展(LTP)、肝内远处复发(IDR)、累积无病生存(DFS)、无LTP生存、无IDR生存和总生存。我们还分析了相关的危险因素。结果:共纳入139例患者，中位随访时间64个月，11 ~ 72个月不等。消融完全率为98.56%。69例(49.64%)出现肝内复发(LTP, n = 15;IDR, n = 55)。1年、3年和5年累计DFS、无ltp生存率和无idr生存率分别为74.82、94.46和78.75%;54.68、88.03、61.79%;51.80%、85.67%、60.17%。在多变量分析中，肿瘤大小> 4 cm是LTP的唯一重要危险因素。碱性磷酸酶(ALP)水平和肿瘤数量是IDR的独立危险因素;α-胎蛋白(AFP)水平> 400µg/L及复发时间是影响总生存期的危险因素。结论:ms - rfa是早期肝癌局部控制的有效方法。早期HCC合并多发高alp肿瘤复发率较高，以IDR型为主。早期HCC高AFP水平和较短的初始复发间隔导致预后较差。因此，在这些情况下，肝移植或手术切除等治疗可能是一个很好的策略。
Risk factors for the recurrence of early hepatocellular carcinoma treated by percutaneous radiofrequency ablation with a multiple-electrode switching system: a multicenter prospective study.
Purpose: To investigate the long-term efficacy of radiofrequency ablation (RFA) with a multiple-electrode switching system (MESS) in the treatment of early hepatocellular carcinoma (HCC) and evaluate the patterns and risk factors of intrahepatic recurrence of HCC after RFA.
Methods: In total, 139 patients with early HCC who underwent RFA with MESS as primary treatment at multiple centers were prospectively enrolled according to the inclusion criteria. We evaluated the local tumor progression (LTP), intrahepatic distant recurrence (IDR), the incidence of cumulative disease-free survival (DFS), LTP-free survival, IDR-free survival, and overall survival. We also analyzed the associated risk factors.
Results: A total of 139 patients were included in the study and the median follow-up time was 64 months, ranging from 11 to 72 months. The complete ablation rate was 98.56%. Sixty-nine (49.64%) were found to have intrahepatic recurrence (LTP, n = 15; IDR, n = 55) during follow-up. The 1-year, 3-year and 5-year cumulative DFS, LTP-free survival, and IDR-free survival rates were 74.82, 94.46 and 78.75%; 54.68, 88.03 and 61.79%; and 51.80, 85.67 and 60.17%, respectively. In the multivariable analysis, tumor size > 4 cm was the only important risk factor for LTP. The alkaline phosphatase (ALP) level and the number of tumors were independent risk factors for IDR; α-fetoprotein (AFP) level > 400 µg/L and recurrence interval were risk factors for the overall survival period.
Conclusions: The MESS-RFA is an effective method for local control of tumors in early HCC. Early HCC with multiple high-ALP tumors has a higher rate of recurrence, which mainly occurs in an IDR pattern. Early HCC with high AFP levels and a shorter initial recurrence interval resulted in a poorer prognosis. Thus, treatments such as liver transplantation or surgical resection may be a good strategy in those cases.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
