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Efficacy and safety of computed tomography-guided microwave ablation with fine needle-assisted puncture positioning technique for hepatocellular carcinoma

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World Journal of Gastrointestinal Oncology 2022年第9期14卷 1727-1738页

作者： Ming-Zhi Hao Yu-Bin Hu Qi-Zhong Chen Zhang-Xian Chen Hai-Lan Lin Department of Tumor Interventional Radiology Fujian Medical University Cancer HospitalFujian Cancer HospitalFuzhou 350014Fujian ProvinceChina Department of Fujian Provincial Key Laboratory of Translational Cancer Medicine Fujian Cancer HospitalFuzhou 350014Fujian ProvinceChina

BACKGROUND In microwave ablation(MWA), although computed tomography(CT) scanning can overcome gas interference, it cannot achieve real-time localization. Therefore, the puncture technique is more important in CT-guided *** To compare the fine needle-assisted puncture(FNP) positioning technique and the conventional puncture(CP) technique for the safety and efficacy of CT-guided MWA in treating hepatocellular carcinoma(HCC).METHODS This retrospective study included 124 patients with 166 tumor nodules from February 2018 and June 2021. Seventy patients received CT-guided MWA under the FNP technique(FNP group), and 54 patients received MWA under the CP technique(CP group). Intergroup comparisons were made regarding local tumor progression(LTP), recurrence-free survival(RFS), overall survival(OS), and complications. The influencing variables of LTP and RFS were analyzed through univariate and multivariate *** The 1-, 2-, and 3-year cumulative incidences of LTP in the FNP group were significantly lower than those in the CP group(7.4%, 12.7%, 21.3% vs 13.7%, 32.9%, 36.4%;P = 0.038). The 1-, 2-, and 3-year RFS rates in the FNP group were significantly higher than those in the CP group(80.6%, 73.3%, 64.0% vs 83.3%,39.4%, and 32.5%, respectively;P = 0.008). The FNP technique independently predicted LTP and RFS. Minor complications in the FNP group were lower than those in the CP group(P < 0.001). The difference in median OS was insignificant between the FNP and CP groups(P = 0.229).CONCLUSION The FNP technique used in CT-guided MWA may improve outcomes in terms of LTP, RFS, and procedure-related complications for HCC.

关键词： Hepatocellular carcinoma fine needle puncture Microwave ablation Recurrence-free survival Local tumor progression

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