微波消融与大肝癌肝动脉化疗栓塞：前瞻性分析

StephenW

Microwave ablation versus transarterial chemoembolization in large hepatocellular carcinoma: prospective analysis

April 2015, Vol. 50, No. 4 , Pages 479-484 (doi:10.3109/00365521.2014.1003397)


Ashraf Omar Abdelaziz, Mohamed Mahmoud Nabee Tamer Mahmoud Elbaz, Hend Ibrahim Shousha, Eman Medhat Hassan, Sherif Hamdy Mahmoud, Noha Ali Rashed, Mostafa Mohamed Ibrahim, and Ahmed Hosni Abdelmaksoud
1Endemic Medicine and Hepatogastroenterology Department, Cairo University,
Cairo, Egypt
2Endemic Hepatogastroenterology Department, Kasr Al Ainy Hospital, Faculty of Medicine, Cairo University,Cairo, Egypt
3Diagnostic and Interventional Radiology Department, Cairo University,
Cairo, Egypt
Correspondence: Hend Ibrahim Shousha, Endemic Hepatogastroenterology Department, Kasr Al Ainy Hospital, Faculty of Medicine, Cairo University,
Cairo, Egypt. +20 1005738455. +20 0225326543. [email protected]


Abstract

Objective. Limited therapies are offered for large hepatocellular carcinoma (HCC). It carries dismal prognosis and efforts tried changing its management from a palliative to a curative mode. Transarterial chemoembolization (TACE) is a palliative procedure that may have survival benefit if compared to non-management of large lesions. Microwave ablation (MWA) has emerged as a relatively new technique with promise of larger and faster ablation. We aim to evaluate the efficacy and safety of percutaneous MWA versus TACE for large tumors (5–7 cm) and to assess their effects on local tumor progression and survival. Patients and methods. Sixty-four patients with large lesions are managed in our multidisciplinary HCC clinic and were divided into two groups treated either by MWA or TACE. Complete response rate, local recurrence, de novo lesions, and overall survival analysis are compared between both procedures. Results. Both groups were comparable as regards the demographic and ultrasonographic features. MWA showed higher rates of complete ablation (75%) with fewer sessions, lower incidence of tumor recurrence (p = 0.02), development of de novo lesions (p = 0.03), occurrence of post-treatment ascites (p = 0.003), and higher survival rates (p = 0.04). The mean survival of the microwave group was 21.7 months with actuarial probability of survival at 12 and 18 months 78.2% and 68.4%, respectively. The mean survival of the TACE group was 13.7 months with actuarial probability of survival at 12 and 18 months being 52.4% and 28.6%, respectively. Conclusion. MWA showed better results than TACE in the management of large HCC lesions.
Keywords
hepatocellular carcinoma, microwave ablation, survival, transarterial chemoembolization



Read More: http://informahealthcare.com/doi ... 365521.2014.1003397

StephenW

微波消融与大肝癌肝动脉化疗栓塞：前瞻性分析

2015年4月，卷。 50，4号，页479-484（DOI：10.3109 / 00365521.2014.1003397）


阿什拉夫·奥马尔阿卜杜勒 - 阿齐兹·穆罕默德·马哈茂德Nabee驯马哈茂德Elbaz的，亨德·易卜拉欣手刹，林二汶迈扎特·哈桑，谢里夫Hamdy马哈茂德，诺哈·拉希德·阿里，穆斯塔法·穆罕默德·易卜拉欣和艾哈迈德·胡斯尼Abdelmaksoud
1Endemic医学和Hepatogastroenterology处，开罗大学，
开罗，埃及
2Endemic Hepatogastroenterology处，Kasr铝Ainy医院，医药，开罗大学，开罗，埃及学院
3常用诊断命令和介入放射科，开罗大学，
开罗，埃及
函授：亨德·易卜拉欣手刹，地方病Hepatogastroenterology处，Kasr铝Ainy医院，医药，开罗大学法律系，
埃及开罗。 +20 1005738455. +20 0225326543. [email protected]


抽象

客观的。有限的治疗提供了较大的肝细胞癌（HCC）。它携带预后极差，并试图改变其管理从治标到治疗方式的努力。肝动脉化疗栓塞（TACE）是可能有生存获益，如果比较大的病变非管理治标不治本的过程。微波消融（MWA）已成为一个相对较新的技术，以更大，更快消融的承诺。我们的目标是评估疗效和经皮MWA安全与TACE的大肿瘤（5-7厘米），并评估其对局部肿瘤进展和生存的影响。病人和方法。 64例大病灶在我们的多学科HCC诊所的管理和分成由MWA或TACE治疗或者两组。完全缓解率，局部复发，新发病灶，和总生存期分析两种方法之间进行比较。结果。两组具有可比性至于人口和超声表现。 MWA显示完全消融（75％）与较少的会话率较高，肿瘤复发（P = 0.02）的发病率较低，从头病变（P = 0.03），出现治疗后腹水（P = 0.003）的发展，更高的存活率（P = 0.04）。微波组的平均存活为21.7个月的存活精算概率在12至18个月，分别78.2％和68.4％。 TACE组的平均生存期为13.7个月，生存精算概率在12至18个月分别为52.4％和28.6％。结论。 MWA表现出比TACE中大肝癌病变的管理更好的结果。
关键词
肝癌，微波消融，生存，肝动脉栓塞化疗