Clinical efficacy of ultrasound-guided percutaneous thermal ablation for malignant liver tumors adjacent to the heart

doi:10.3877/cma.j.issn.2095-3232.2023.01.010

Abstract

Abstract:

Objective

To evaluate the efficacy and safety of ultrasound-guided percutaneous thermal ablation for patients with malignant liver tumors adjacent to the heart.

Methods

Clinical data of 45 patients with malignant liver tumors adjacent to the heart who received thermal ablation in the Third Affiliated Hospital of Sun Yat-sen University from June 2018 to December 2020 were retrospectively analyzed. The informed consents of all patients were obtained and the local ethical committee approval was received. Among them, 35 patients were male and 10 female, aged from 40 to 80 years, with a median age of 60 years. The median distance of the lesions to the heart was 3(1-5) mm. The maximum diameter of lesions was 20(8-64) mm. 43 cases were classified as Child-Pugh grade A and 2 cases of Child-Pugh grade B. 39 patients were diagnosed with hepatocellular carcinoma and 6 cases of metastatic liver cancer. The success rate and effective rate of the ablation, local progression rate, progression-free survival and incidence of complications were observed.

Results

45 lesions were detected in 45 patients and the surgeries of all patients were completed successfully. Among them, 31 cases received radiofrequency ablation, 11 cases of microwave ablation and 3 casesof radiofrequency combined with microwave ablation. 10 cases underwent ablation assisted by artificial ascites and 1 case by artificial hydrothorax and ascites. No active bleeding or abdominal tumor implantation was found during the perioperative period. The incidence of major postoperative complications was 9%(4/45), including 1 case of biliary infection, 1 case of liver abscess, 1 case of sinus arrhythmia and 1 case of heart failure, which were mitigated after active interventions. The success rate and effective rate of thermal ablation were both 100%(45/45). The local progression rate was 7%(3/45), the median progression-free survival was 10 months, and the overall 3-year survival rate was 97.7%.

Conclusions

Assisted by appropriate approaches, ultrasound-guided percutaneous thermal ablation is safe and effective for treating malignant liver tumors adjacent to the heart.

Key words: Liver neoplasms, Ultrasonography, interventional, Thermal ablation, Radiofrequency ablation, Microwave ablation, Treatment outcome

Qingjin Zeng, Liwen Zhao, Yuxuan Wu, Xuqi He, Lanxia Zhang, Xuan Yu, Na He, Rongqin Zheng, Kai Li. Clinical efficacy of ultrasound-guided percutaneous thermal ablation for malignant liver tumors adjacent to the heart[J]. Chinese Journal of Hepatic Surgery(Electronic Edition), 2023, 12(01): 49-54.

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URL: https://zhgzwkssxdzzz.cma-cmc.com.cn/EN/10.3877/cma.j.issn.2095-3232.2023.01.010

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Figures/Tables 4

References 23

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组别	例数^a	年龄[岁，M（Min~Max）]	性别（例，男/女）	病灶直径[mm，M（Min~Max）]	胸腹水辅助（例）	手术时间[min，M（Min~Max）]	术后并发症（例）	技术成功（例）	完全消融（例）	LTP（例）
射频组	31	60（40~80）	25/6	20（11~63）	8	70（33~175）	2	31	31	2
微波组	11	52（42~72）	7/4	25（10~64）	2	40（20~97）	2	11	11	1
统计值		Z=0.857	χ²=0.527	Z=-1.217	χ²=0.010	Z=2.988	χ²=0.293	-	-	χ²=0.000
P值		0.397	0.468	0.231	0.922	0.005	0.589	-	-	1.000

组别	例数^a	年龄[岁，M（Min~Max）]	性别（例，男/女）	病灶直径[mm，M（Min~Max）]	胸腹水辅助（例）	手术时间[min，M（Min~Max）]	术后并发症（例）	技术成功（例）	完全消融（例）	LTP（例）
射频组	31	60（40~80）	25/6	20（11~63）	8	70（33~175）	2	31	31	2
微波组	11	52（42~72）	7/4	25（10~64）	2	40（20~97）	2	11	11	1
统计值		Z=0.857	χ²=0.527	Z=-1.217	χ²=0.010	Z=2.988	χ²=0.293	-	-	χ²=0.000
P值		0.397	0.468	0.231	0.922	0.005	0.589	-	-	1.000

组别	例数	年龄[岁，M（Min~Max）]	性别（例，男/女）	病灶直径[mm，M（Min~Max）]	手术时间[min，M（Min~Max）]	术后并发症（例）	技术成功（例）	完全消融（例）	LTP（例）
辅助组	11	71（51~80）	7/4	23（11~63）	95（54~175）	1	11	11	2
非辅助组	34	56（40~74）	28/6	20（8~64）	64（20~160）	3	34	34	4
统计值		Z=3.326	χ²=0.776	Z=1.530	Z=3.150	χ²=0.000	-	-	χ²=0.001
P值		0.002	0.378	0.133	0.003	1.000	-	-	0.973

组别	例数	年龄[岁，M（Min~Max）]	性别（例，男/女）	病灶直径[mm，M（Min~Max）]	手术时间[min，M（Min~Max）]	术后并发症（例）	技术成功（例）	完全消融（例）	LTP（例）
辅助组	11	71（51~80）	7/4	23（11~63）	95（54~175）	1	11	11	2
非辅助组	34	56（40~74）	28/6	20（8~64）	64（20~160）	3	34	34	4
统计值		Z=3.326	χ²=0.776	Z=1.530	Z=3.150	χ²=0.000	-	-	χ²=0.001
P值		0.002	0.378	0.133	0.003	1.000	-	-	0.973

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