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Strategies of percutaneous microwave ablation in treatment of large hepatocellular carcinoma |
CHEN Jian,QIAN Xiaoqin,CHEN Xiao,JIN Xia,and YAN Chaohui |
Department of Ultrasound,Jiangsu Provincial Armed Police Corps Hospital,Yangzhou 225003,China |
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Abstract Objective To evaluate the strategies of percutaneous microwave ablation in the treatment of large hepatocellular carcinoma, and the principle of needle arrangement, the treatment effect and its complications. Methods Ninely-nine patients with hepatocellular carcinoma (134 nodules) underwent microwave ablation treatment with guided by ultrasound . According to the size and the shape of lesions and their surrounding anatomic structures, different therapeutic plans and different needle distribution modes were applied,leading to relevant curative effects which were evaluated. Results Complete ablation rates were 97.78%(44/45),94.44%(34/36), and 73.68%(14/19) in those nodules of 4.1-5.0 cm, 5.1-6.0 cm, and >6 cm respectively,with a total ablation rate of 94.03%(124/134). Ultrasound-guided microwave ablation arangements were successful in 46 lessions neibouring to vital anatomic strutures,and the complete tumor ablation rate was 86.05% (37/43). Total complication rate after microwave ablation was 21.21 (21/99)%, and after symptomatic treatment, all complications disappeared naturally. Local recurrence rate was 18.66% (25/134), and distant recurrence rate was 15.15% (15/99). 1, 2, 3, 5 year accumulative total survival rates were 89.90% (89/99),71.83%(51/71), 53.06%(26/49),28.57%(4/14), respectirely. Conclusion The conbined plan of carpet-mode ablation,fire wall ablation strategy and extending ablation range is safe, effective, and feasible, in treatment of large HCC neibouring to vital anatiomic structures.
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Received: 22 March 2013
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[1] |
吕明德.影像引导肝癌消融治疗的效果和临床地位[J].中国普外基础与临床杂志,2006,13(2):138-139.
|
[1] |
吕明德.影像引导肝癌消融治疗的效果和临床地位[J].中国普外基础与临床杂志,2006,13(2):138-139.
|
[2] |
梁 萍,董宝玮,于晓玲,等.超声引导经皮微波消融治疗肝转移癌疗效评价[J].中华医学杂志,2006, 86(12): 806-810.
|
[2] |
梁 萍,董宝玮,于晓玲,等.超声引导经皮微波消融治疗肝转移癌疗效评价[J].中华医学杂志,2006, 86(12): 806-810.
|
[3] |
Seki T, Wakabayashi M, Nakagawa T, et al. Percutaneous microwave coagulation therapy for small hepatocellular carcinoma:comparison with percutaneous ethanol injection therapy[J]. Cancer,1999,85: 1694-1702.
|
[3] |
Seki T, Wakabayashi M, Nakagawa T, et al. Percutaneous microwave coagulation therapy for small hepatocellular carcinoma:comparison with percutaneous ethanol injection therapy[J]. Cancer,1999,85: 1694-1702.
|
[4] |
Ryosuke I,Toshihito S, Kozo I, et al. Percutaneous microwave coagulation therapy for hepatocellular carcinoma: Increased coagulation diameter using a new electrode and microwave generator[J].Oncology Reports, 2010,24: 621-627.
|
[4] |
Ryosuke I,Toshihito S, Kozo I, et al. Percutaneous microwave coagulation therapy for hepatocellular carcinoma: Increased coagulation diameter using a new electrode and microwave generator[J].Oncology Reports, 2010,24: 621-627.
|
[5] |
Kuang M, Lu M D, Xie X Y, et al. Liver cancer: Increased microwave delivery to ablation zone with cooled-shaft antenna-Experimental and clinical studies[J]. Radiol, 2007,242:914-924.
|
[5] |
Kuang M, Lu M D, Xie X Y, et al. Liver cancer: Increased microwave delivery to ablation zone with cooled-shaft antenna-Experimental and clinical studies[J]. Radiol, 2007,242:914-924.
|
[6] |
YU Z C, LIU W C, FAN L, et al. The efficacy and safety of percutaneous microwave coagulation by a new microwave delivery system in large hepatocellular carcinomas:Four case studies[J].Int J Hyperthermia, 2009,25(5):392-398.
|
[6] |
YU Z C, LIU W C, FAN L, et al. The efficacy and safety of percutaneous microwave coagulation by a new microwave delivery system in large hepatocellular carcinomas:Four case studies[J].Int J Hyperthermia, 2009,25(5):392-398.
|
[7] |
陈 建,刘英棣,施丁一,等.肝血流影响经皮微波凝固体积的实验研究[J].肝脏,2001,6(3):210-211.
|
[7] |
陈 建,刘英棣,施丁一,等.肝血流影响经皮微波凝固体积的实验研究[J].肝脏,2001,6(3):210-211.
|
[8] |
陈 建,徐有坤,朱东升,等.扩展经皮微波凝固肝组织范围的实验研究[J].中华超声影像学杂志,2003,12(3):165-168.
|
[9] |
刘 岩,申宝忠,李任飞,等.肝动脉栓塞对微波凝固范围影响的实验研究[J].中华肿瘤杂志,2003,25(6):546-549.
|
[8] |
陈 建,徐有坤,朱东升,等.扩展经皮微波凝固肝组织范围的实验研究[J].中华超声影像学杂志,2003,12(3):165-168.
|
[10] |
陈敏华,杨 薇,严 昆,等.肝癌射频治疗计算方案的制定及应用研究[J].中华医学杂志,2004,84(3):203-208.
|
[9] |
刘 岩,申宝忠,李任飞,等.肝动脉栓塞对微波凝固范围影响的实验研究[J].中华肿瘤杂志,2003,25(6):546-549.
|
[11] |
Izumi N, Asahina Y, Noguchi O, et al. Risk factors for distant recurrence of hepatocellular carcinoma in the liver after complete coagulation by microwave or radiofrequency ablation[J]. Cancer,2001,91:949-956.
|
[10] |
陈敏华,杨 薇,严 昆,等.肝癌射频治疗计算方案的制定及应用研究[J].中华医学杂志,2004,84(3):203-208.
|
[11] |
Izumi N, Asahina Y, Noguchi O, et al. Risk factors for distant recurrence of hepatocellular carcinoma in the liver after complete coagulation by microwave or radiofrequency ablation[J]. Cancer,2001,91:949-956.
|
|
|
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