医学
肝细胞癌
阶段(地层学)
比例危险模型
射频消融术
烧蚀
危险系数
肝癌
内科学
胃肠病学
回顾性队列研究
外科
置信区间
生物
古生物学
作者
Tae Wook Kang,Hyo Keun Lim,Min Woo Lee,Youngsun Kim,Hyunchul Rhim,Won Jae Lee,Geum‐Youn Gwak,Yong Han Paik,Ho Yeong Lim,Min Ji Kim
出处
期刊:Radiology
[Radiological Society of North America]
日期:2015-07-01
卷期号:276 (1): 274-285
被引量:106
标识
DOI:10.1148/radiol.15141215
摘要
Purpose To evaluate the frequency, risk factors, and clinical significance of aggressive intrasegmental recurrence (AIR) found after radiofrequency (RF) ablation for hepatocellular carcinoma (HCC). Materials and Methods Institutional review board approval was obtained for this retrospective study. Between March 2005 and December 2010, 539 patients (414 men, 125 women; mean age, 57.91 years; age range, 30–82 years) underwent ultrasonography-guided percutaneous RF ablation as a first-line treatment for a single HCC classified as Barcelona Clinic Liver Cancer (BCLC) stage 0 or A. AIR of HCC was defined as (a) initial tumor recurrence with disease-free status at least 6 months after initial RF ablation and (b) the simultaneous development of multiple nodular (at least three) or infiltrative tumor recurrence in the treated segment. Patients were stratified into two groups: those with AIR (n = 20) and those without AIR (n = 519) during follow-up. Risk factors for AIR were assessed with logistic regression analysis, and risk factors for long-term overall survival were assessed with time-dependent Cox proportional hazard models. Results In a median follow-up period of 49 months (range, 6–95 months), AIR was observed in 3.7% of the patients (20 of 539 patients), with the frequency increasing to 15% in the subgroup with periportal HCC (11 of 72 patients). AIRs manifested as either multiple nodular type (n = 14, BCLC stage A or B) or diffusely infiltrative type with tumor thrombus formation (n = 6, BCLC stage C). At multivariate analysis, periportal tumor location and younger patient age were significant risk factors for AIR. The presence of AIR during the follow-up period has a significant effect on the overall survival rate (hazard ratio = 5.72, P = .002). Conclusion The overall frequency of AIR after RF ablation for HCC was low, with periportal location and patient age showing a significant relationship to the development of AIR. The occurrence of AIR had an adverse effect on overall survival rate. © RSNA, 2015
科研通智能强力驱动
Strongly Powered by AbleSci AI