[Efficacy of microwave ablation in treatment of hepatocellular carcinoma within the Milan criteria: a report of 696 cases].

• DOI: 10.3760/cma.j.issn.1007-3418.2017.05.007
• Publication Date: 2017-05-20
• Authors: Yingmei Wang; Guojun Qian; Yanchang Xu; N Wang; Yuhan Sheng
• Keywords: Microwave ablation; Milan criteria

Objective: To investigate the efficacy of microwave ablation in treatment hepatocellular carcinoma (HCC) within Milan criteria and to differences clinical tumors with different sizes. Methods: A retrospective analysis was performed on data patients HCC who received our hospital from January 2011 2013. The complete rate, incidence rate major complications, recurrence overall survival were analyzed outcomes compared between two groups followed up for 3.4-61.8 months. Kaplan-Meier method used calculate local distant rate. Comparison rates made by chi-square test comparison log-rank test. Results: total 696 involving 801 included this study. 93.8% (653/696) complications 1.7% (12/696). median time 59.6 months 1-, 2-, 3-year 94.8%, 82.2%, 71.7%, respectively. 13.4% (93/696) intrahepatic metastasis 40.1% (279/696). 48.1% (335/696), 22.9%, 38.4%, 46.8%, There no significant tumor sizes (diameters≤3 cm 3-5 cm) (P = 0.12; P 0.61; 0.61). Conclusion: Microwave is a safe effective modality criteria. And there are safety, effectiveness, long-term (diameters ≤3 cm). However, if operator's experience not rich cannot accurately use conformal make an individualized treatment, diameter should be carefully treated using avoid residual after treatment.目的： 进一步明确米兰标准内肝细胞癌行微波消融治疗的疗效，亚组分析不同大小肿瘤行微波消融治疗的疗效区别。 方法： 回顾性分析2011年1月至2013年1月行微波消融治疗的米兰标准内肝细胞癌病例资料，分析微波消融治疗的完全消融率、严重并发症发生率、复发率及总生存率，比较不同大小肿瘤行微波消融治疗后总生存率等的差异，随访时间3.4～61.8个月。各组率的比较采用χ(2)检验；总体生存率、局部复发率及远处复发率等采用Kaplan-Meier法计算，各组生存率的比较采用Log-rank检验。 结果： 共纳入696例，消融治疗801处病灶，完全消融率为93.8%（653/696），严重并发症发生率为1.7%（12/696）。中位生存期为59.6个月，1、2、3年总生存率分别为94.8%、82.2%、71.7%；局部复发率为13.4%（93/696），肝内远处转移率为40.1%（279/696），肝内总复发率为48.1%（335/696），1、2、3年复发率分别为22.9%、38.4%、46.8%。亚组分析表明，肿瘤最大直径3～5 cm组及≤3 cm组，在完全消融率、严重并发症发生率及总生存率方面差异无明显统计学意义（P值分别为0.12、0.61、0.61）。 结论： 对于米兰标准内肝细胞癌，微波消融是一种安全有效的治疗方式，而对于直径≤3 cm及3～5 cm的肿瘤，微波消融的安全性、有效性及远期疗效并无明显区别；但如果消融治疗经验不丰富，不能准确运用适形消融及把握个体消融策略，对于治疗直径3～5 cm的肿瘤，应该谨慎处理，避免治疗后肿瘤残留等情况发生。.