[The efficacy and safety of computed tomography-guided percutaneous cryoablation for malignant liver tumors at high-risk sites]
- PMID: 39069864
- DOI: 10.3760/cma.j.cn112138-20240113-00032
[The efficacy and safety of computed tomography-guided percutaneous cryoablation for malignant liver tumors at high-risk sites]
Abstract
Objective: To assess the efficacy and safety of computed tomography (CT)-guided percutaneous cryoablation in treating malignant liver tumors located explicitly at high-risk sites. Methods: Data were collected retrospectively from patients with malignant liver tumors undergoing percutaneous cryoablation at Tianjin Medical University Cancer Hospital between January 2018 and December 2021. In all, 46 patients with malignant liver tumors at non-high-risk sites were matched 1∶1 according to the maximum tumor diameter. Technical success rate, complete ablation rate, and complications at 12 and 24 months post-surgery were evaluated. A statistical analysis of the ablation effect difference between the high-risk site and non-high-risk site groups was conducted. Univariate and multivariate logistic regression analyses were performed to identify risk factors. Results: Both groups demonstrated a 100% intraoperative technical success rate, and no major complications related to cryoablation were observed. The complete ablation rate was 82.6% (38/46) and 71.7% (33/46) in the high-risk group and 84.8% (39/46) and 73.9% (34/46) in the non-high-risk group at 12 and 24 months, respectively. There was no significant difference in complete ablation rates between the two groups (P>0.05). Multivariate analysis identified the distance between the tumor edge and high-risk site ≤5 mm and preoperative trans-arterial chemoembolization (TACE) treatment as independent risk factors for cryoablation effect. Conclusion: CT-guided percutaneous cryoablation is a safe and effective approach for patients with malignant liver tumor at high-risk sites. Our results emphasize the importance of proper preoperative planning and intraoperative manipulation.
目的： 分析CT引导下经皮冷冻消融治疗高危部位肝恶性肿瘤的疗效和安全性。 方法： 回顾性收集2018年1月到2021年12月在天津医科大学肿瘤医院接受经皮冷冻消融治疗的肝恶性肿瘤患者资料，通过肿瘤最大径进行1∶1匹配同期收治的46例非高危部位肝恶性肿瘤患者。评估技术成功率及12个月和24个月的完全消融率及并发症情况。统计分析高危部位组和非高危部位组之间患者消融效果差异。采用单因素分析、多因素logistic回归分析独立危险因素。 结果： 两组术中技术成功率均为100%，未发生严重并发症。高危部位组和非高危部位组12、24个月的完全消融率分别为82.6%（38/46）比84.8%（39/46）、71.7%（33/46）比73.9%（34/46），两组间差异无统计学意义（均P>0.05）。多因素分析结果显示，肿瘤边缘至高危部位距离≤5 mm、术前是否接受TACE治疗是影响冷冻消融效果的独立危险因素。 结论： CT引导下经皮冷冻消融治疗高危部位的肝恶性肿瘤安全有效，但需要合理的术前规划和谨慎术中操作。.