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目的分析超声引导经皮微波消融(MWA)治疗肝转移癌的疗效。方法应用超声引导下经皮MWA技术治疗肝转移癌共27例69个结节,直径为0.9～13.2(3.0±2.0)cm。观察局部疗效、局部复发率、再发率及生存率。所有病例均签署知情同意书。结果判断局部疗效的完全消融(CA)率为92.8%(64/69),其中,结节直径<3.0cm、3.0～5.0cm及≥5.0cm组的CA率分别为100%(34/34)、92.3%(24/26)和66.7%(6/9),直径≥5.0cm组CA率明显低于其他两组(P<0.05)。结节局部复发率为9.4%(6/64),其中结节直径<3.0cm、3.0～5.0cm及≥5.0cm组的结节复发率分别为2.9%(1/34)、16.7%(4/24)和16.7%(1/6)。判断肝内其他部位出现新转移灶的再发率为44.4%(12/27)。随访时间为3～34(17.0±8.7)个月。6个月、1年及2年的累积生存率分别为88.9%、63.0%及34.4%,平均生存期17.8个月,中位生存期19.0个月。结论经皮MWA治疗肝转移癌的局部疗效满意,对复发或再发病例可以反复治疗,能够延长生存期。
Objective To analyze the efficacy of ultrasound guided percutaneous microwave ablation (MWA) in the treatment of liver metastases. Methods A total of 27 nodules and 27 nodules were treated by ultrasound-guided percutaneous MWA in the treatment of liver metastases with a diameter of 0.9 ~ 13.2 (3.0 ± 2.0) cm. To observe the local efficacy, local recurrence rate, recurrence rate and survival rate. Informed consent was signed in all cases. Results The total CA rate of local curative effect was 92.8% (64/69). Among them, the CA rates of nodule diameter <3.0cm, 3.0 ~ 5.0cm and ≥5.0cm were 100% (34/34) , 92.3% (24/26) and 66.7% (6/9) respectively. The CA rate in the group with diameter≥5.0cm was significantly lower than that in the other two groups (P <0.05). The recurrence rate of nodules was 9.4% (6/64). The nodular recurrence rates were 2.9% (1/34) and 16.7% (4) in nodules with diameter <3.0cm, 3.0 ~ 5.0cm and ≥5.0cm respectively / 24) and 16.7% (1/6). The rate of new metastases in other parts of the liver was 44.4% (12/27). The follow-up time ranged from 3 to 34 (17.0 ± 8.7) months. The cumulative survival rates at 6 months, 1 year and 2 years were 88.9%, 63.0% and 34.4%, respectively. The mean survival time was 17.8 months and the median survival time was 19.0 months. Conclusions The percutaneous MWA treatment of liver metastases of the local efficacy of satisfactory, recurrence or recurrent cases can be repeated treatment, can prolong survival.