射频消融与肺转移灶切除术治疗结直肠癌根治性切除术后肺转移患者疗效的对比研究

目的：比较射频消融（radiofrequency ablation,RFA）术与肺转移灶切除术治疗结直肠癌（colorectal cancer,CRC）根治性切除术后肺转移患者的疗效。方法：回顾性分析80例CRC根治性切除术后肺转移患者的临床资料,根据肺转移局部治疗方式分为肺转移灶切除术组（33例）和RFA组（47例）。比较2组患者的总生存（overall survival,OS）和无进展生存（progression-free survival,PFS）,并分析影响患者预后的因素。结果：肺转移灶切除术组和RFA组患者的3年PFS率分别为42.4%和31.9%,3年OS率分别为75.8%和72.3%。2组患者PFS和OS的差异均无统计学意义（P> 0.05）。多因素分析结果显示,肺转移灶最大直径、术前血清癌胚抗原（carcinoembryonic antigen,CEA）水平和肺外转移史是CRC根治性切除术后肺转移患者OS的独立影响因素（P <0.05）。此外,术前血清癌胚抗原水平和肺外转移史也是CRC根治性切除术后肺转移患者PFS的独立影响因素（P <0.05）。结论...     

射频消融治疗肝脏恶性肿瘤的临床价值

目的:探讨射频消融(RFA)治疗肝脏恶性肿瘤的临床疗效及并发症.方法:对259例肝脏恶性肿瘤患者进行RFA治疗.肝细胞肝癌(HCC)223例行270人次的RFA,病灶总数372枚,平均1.4枚,肿瘤平均最大直径2.4±1.3cm,其中临床分期为Ⅰ期的61例;肝转移癌(MLC)36例行44人次的RFA,病灶总数72枚,平均1.6枚,肿瘤平均最大直径2.6±1.6cm.全组病例的治疗通过经皮穿刺和开腹两种途径.治疗原则为消融范围超过瘤周0.5～1.0cm.结果:RFA治疗后1个月行增强CT检查,HCC完全消融率97.3%(362/372),MLC完全消融率98.6%(71/72).随访2～65个月,HCC局部复发率7.8%(29/372),1、3、5年生存率分别为87.7%、55.3%、32.9%,其中61例Ⅰ期HCC患者1、3、5年生存率分别为97.6%、86.1%、47.0%;MLC局部复发率11.1%(8/72).中位生存期16～24个月.HCC患者RFA的严重并发症发生率2.2%(6/270),MLC治疗中出现2例较严重的并发症.结论:RFA对于肝脏恶性肿瘤尤其HCC是一种有效的治疗手段,而且安全、并发症少,具有重要的临床价值.     

经皮微波消融治疗鼻咽癌局限肝转移的疗效分析

背景与目的：局限性肝转移瘤由于数目、大小可控,局部微创治疗可以有效提高患者的生存期,微波消融已经成为肝转移瘤的重要治疗手段。该研究旨在探讨经皮肝穿刺微波消融治疗局限性鼻咽癌肝转移瘤的应用价值。方法：收集湖南省肿瘤医院自2011年9月—2014年10月共26例晚期放化疗失败的鼻咽癌肝脏转移患者的临床资料。患者肿瘤病灶数目小于等于3个,直径小于等于5 cm,且无其他远处转移病灶。在B超引导下行经皮肝穿刺微波消融治疗,26例患者共完成43次消融治疗,术后1个月复查肝功能、增强CT或者MRI,在mRECIST标准评价肿瘤治疗疗效。观察患者术后并发症,统计患者无疾病进展时间(progression-free survival,PFS)及总生存期(overall survival,OS)。结果：26例患者共53个病灶,其中完全消融(complete ablation,CA)20例(20/26,77.0%),部分消融(part ablation,PA)3例(3/26,11.5%),整体有效率(CA+PA)为88.5%,无严重并发症出现,26例患者0.5、1和2年生存率分别为96.1%、65.3%和23.0%,PFS为11.4个月,中位生存期(median survival time,MST)为17.8个月,OS为23.7个月。结论：经皮肝穿刺微波消融治疗局限性鼻咽癌肝转移瘤是微创、安全、有效的治疗方法。     

肝动脉栓塞化疗后射频消融联合酒精消融对原发性肝癌的疗效评价

目的　探讨肝动脉栓塞化疗(TACE)后,CT导向下射频消融(RFA)联合无水乙醇消融(PEI)对原发性肝癌(HCC)的治疗效果。方法　经病理、AFP或典型影像学诊断证实的HCC 1 5 0例,每例肝内的病灶数目<3个,病灶大小3.1～7.9cm ,平均直径5 .5cm。全部患者按就诊单双日分为对照组和联合组。对照组74例,TACE后2周行单纯RFA ;联合组76例,TACE后2周行射频消融,间隔2 0～30d后再行PEI。结果　对照组的完全坏死率为75 .8%,联合组为89.5 %,两组间差异有统计学意义(P <0 .0 5 )。结论　HCC患者经TACE后,行CT导向下RFA联合PEI的疗效明显优于单纯RFA。     

鼻咽癌同步推量同步放化疗与常规分割后缩野同步放化疗的疗效及毒性反应对比分析

目的 对比分析鼻咽癌同步推量同步放化疗与常规分割后缩野同步放化疗的疗效及毒性反应。方法 回顾性分析自2007年1月—2008年12月于我院接受同步放化疗后的90例鼻咽癌患者,其中同步推量组45例,常规分割后缩野组45例。对比分析两组患者的5年总生存率(Overall survival,OS)、无进展生存率(Progression free survival,PFS)、无局部区域复发生存率(Loco-regional recurrence-free survival,LRFS)以及毒性反应。结果 同步推量组5年OS、PFS、LRFS分别为84.4%、75.6%、88.9%,常规分割后缩野组5年OS、PFS、LRFS分别为82.2%、71.1%、86.7%,两组OS、PFS、LRFS差异无统计学意义。常规分割后缩野组脑干、脊髓、腮腺放疗反应要轻于同步推量组。结论 在调强放疗时代,应用同步推量同步放化疗和常规分割后缩野同步放化疗两种方式在预后方面无统计学差异,而常规分割后缩野组放疗毒性较轻。     

肝细胞癌射频消融治疗后肿瘤残留的危险因素及预后分析

目的 探讨肝细胞癌(HCC)射频消融(RFA)治疗后肿瘤残留的危险因素及预后.方法 回顾性分析2001年5月至2007年3月114例经RFA治疗的HCC患者临床资料,分析可能与RFA后肿瘤残留有关的临床因素以及残留HCC的预后.结果 114例HCC患者经RFA治疗一次后,完全消融90例,肿瘤残留24例.90例肿瘤完全消融患者的中位生存期为40个月,24例肿瘤残留患者的中位生存期为29个月,二者差异无统计学意义(P=0.242).在24例肿瘤残留患者中,经再次治疗后达到无肿瘤残留者11例,其中位生存期为53个月;经再次治疗后仍有残留者13例,其中位生存期为28个月.RFA治疗一次后肿瘤完全消融患者与再次治疗后达到无肿瘤残留患者的中位生存期比较,差异无统计学意义(P=0.658);与再次治疗后仍有肿瘤残留患者的中位生存期比较,差异有统计学意义(P=0.012).多因素分析表明,肿瘤＞3 cm(P=0.007)和靠近大血管(P=0.042)是HCC经RFA治疗后肿瘤残留的独立危险因素.结论 肿瘤＞3 cm和靠近大血管是HCC行RFA治疗后肿瘤残留的独立危险因素.对未能达到完全消融的HCC患者,应积极采取进一步治疗措施,争取达到完全根治肿瘤,以改善预后.     

DNA损伤同源重组修复相关蛋白在软组织平滑肌肉瘤中的表达及其预后意义

摘 要：［目的］ 探讨DNA损伤同源重组修复相关蛋白在软组织平滑肌肉瘤 (leiomyosarcoma,LMS) 中的表达及其预后意义。［方法］ 采用免疫组化SP法检测61例LMS中RAD51 重组酶 (RAD51)、 RAD52同源性DNA修复蛋白(RAD52)、ATM丝氨酸／苏氨酸(ATM)及ATR丝氨酸／苏氨酸(ATR)的表达。［结果］ 61例LMS患者的1年、5年和10年生存率分别为87％、46%和19%;中位生存期（overall survival,OS）为44.7个月,中位无病生存期(disease-free survival,DFS)为30.3个月,中位无进展生存期(progress-free survival,PFS)为17.0个月。LMS中RAD51、RAD52、ATM及ATR的阳性表达率分别为45.9%（28/61）、62.3%（38/61）、16.4%（10/61）和60.7%（37/61）。Kaplan-Meier分析显示RAD51,RAD52,ATM和ATR是影响LMS患者OS的重要因素(P<0.05)。Cox回归分析显示RAD52、ATM和ATR是影响LMS患者OS的独立预后因子(P<0.05)。此外,ATM是LMS患者DFS的独立影响因子(P<0.05),而RAD52是PFS的独立影响因子(P<0.05)。［结论］ DNA 损伤同源重组修复相关蛋白RAD52、ATM和ATR可作为评估LMS预后的独立因子。     

微波消融治疗肺肿瘤的相关预后因素分析

目的:分析微波消融治疗肺部肿瘤患者预后的相关影响因素。方法:选取解放军第九六零医院和山东省第二人民医院2014年03月到2021年04月收治的行肺部微波消融术(microwave ablation, MWA)的肿瘤患者,重点回顾性分析微波消融患者的总生存期(overall survival, OS)、无进展生存期(progression-free-survival, PFS)及不良反应、并发症的相关影响因素。结果:54例患者入组,共消融75个病灶。单因素及多因素分析后显示：肿瘤位置：胸壁2 cm之外;气管、大血管和心脏2 cm之外的患者具有更长的PFS及OS(P均<0.05)。消融患者中40例(74.1%)患者出现了不良反应及并发症,消融的功率越大,不良反应和并发症的发生概率越高(P<0.05)。不良反应及并发症均通过相应的治疗得到缓解,没有相关的死亡病例发生。结论:肿瘤位置是微波消融治疗肺部肿瘤患者PFS和OS的独立预后因素,同时,消融功率的大小与不良反应、并发症的发生率有关。     

子宫内膜浆液性癌与高级别癌的预后生存比较（附70例临床分析）

目的：探讨子宫内膜浆液性癌（uterine serous carcinoma,USC）与高级别癌（grade 3 endometrioid carcinoma,G3EC）的预后差异。方法：回顾分析2012年7月至2018年1月于四川省肿瘤医院初次接受治疗的70例Ⅰ～Ⅳ期USC与G3EC患者的临床病理资料。使用Kaplan-Meier法构建生存曲线估计总生存率（overall survival,OS）和无进展生存率（progression-free survival,PFS）的差异,使用单因素和COX多因素回归分析影响患者预后的因素。结果：相较G3EC患者,USC患者5年生存率低（54.8%vs 84.6%,P=0.006）且肿瘤复发转移风险高（35.5%vs 10.3%,P=0.035）,单因素分析显示,病理类型为USC、腹腔冲洗液细胞学阳性、原发灶超出子宫体、未获得满意减瘤手术、中晚期肿瘤是影响两组患者PFS及OS的不良预后因素。多因素分析显示,原发灶超出子宫体是两组患者PFS和OS的独立不良预后因素[风险比（95%置信区间）分别为19.48(1.86～204.00)和10.49(1...     

65例可切除老年胃癌临床病理特征和预后分析

目的:分析65例可切除老年胃癌患者的临床病理特征和预后。方法:回顾性分析病理证实的65例年龄≥65岁老年可切除胃癌患者的临床病理特征和预后。60例(92.3%)患者行R0切除。62例(95.4%)患者行D2术。18例(27.7%)患者行术后辅助化疗。Kaplan-Meier法分析生存率,Log-rank检验比较组间生存差异。结果:65例患者中,男49例,女16例。60例(92.3%)患者为腺癌。TNM分期为I-II和III期患者分别为15例(23.1%)和50例(76.9%)。32例(49.2%)患者伴有合并症,6例(9.2%)伴有1个以上合并症。全组患者2年总生存率(overall survival,OS)、无进展生存率(progression-free survival,PFS)和癌症特异生存率(cancer-specific survival,CSS)分别为42.6%、28.4%和49.0%。单因素分析发现,N0-1患者的预后明显优于N2-3的患者,2年OS、PFS和CSS分别为77.9%和31.6%(P=0.010)、78.6%和16.3%(P=0.002)以及83.1%和37.3%(P=0.023)。死亡原因分析发现,33例死亡患者中,肿瘤相关死亡25例(75.8%),治疗相关或合并症相关死亡8例(24.2%)。结论:可切除老年胃癌的合并症多见,治疗相关或合并症相关死亡多见,N分期是最重要的临床预后因素。     

Combined radiofrequency ablation and ethanol injection versus repeat hepatectomy for elderly patients with recurrent hepatocellular carcinoma after initial hepatic surgery

Purpose: To retrospectively compare the efficacy and safety of combined radiofrequency ablation and percutaneous ethanol injection (RFA–PEI) with repeat hepatectomy for elderly patients with initial recurrent hepatocellular carcinoma (HCC) after hepatic surgery.

Methods: From January 2009 to June 2015, 105 elderly patients (≥70?years) who underwent RFA–PEI (n?=?57) or repeated hepatectomy (n?=?48) for recurrent HCC?≤?5.0?cm were included in the study. The overall survival (OS) and recurrence-free survival (RFS) were analysed with the Kaplan–Meier method and compared by the log-rank test. Non-tumour-related death, complications and hospital stays were assessed. Univariate and multivariate analyses were performed to identify the prognostic significance of the variables in predicting the OS and RFS.

Results: OS rates were 78.2%, 40.8% and 36.7% at 1, 3 and 5?years after RFA–PEI and 76.3%, 52.5% and 42.6% after repeat hepatectomy, respectively (p?=?0.413). Correspondingly, the 1-, 3- and 5-year RFS rates after RFA–PEI and repeat hepatectomy were 69.5%, 37.8%, 33.1% and 73.1%, 49.7%, 40.7%, respectively (p?=?0.465). Non-tumour-related deaths in the RFA–PEI group (2/57) were significantly fewer than those in the repeat hepatectomy group (10/48) (p?=?0.016). RFA–PEI was superior to repeat hepatectomy regarding the major complication rates and length of in-hospital stay (both p?p?=?0.037) and RFS (HR?=?1.866, 95% CI?=?1.064–3.274, p?=?0.030).

Conclusion: RFA–PEI provides comparable OS and RFS to repeat hepatectomy for elderly patients with small recurrent HCC after hepatectomy but with fewer non-tumour-related deaths, major complications and shorter hospital stays.     

原发性肝癌综合介入治疗的疗效分析

目的探讨原发性肝癌综合介入治疗的疗效。方法回顾性分析1126例原发性肝癌患者手术前后行经导管肝动脉化疗栓塞术(TACE)、TACE后射频消融(RFA)治疗、TACE或经导管肝动脉化疗灌注治疗(TAI)后辅以中药和生物治疗的临床资料,分析患者肝功能、肿瘤标志物、癌灶影像资料和生存率等,比较各种综合介入治疗的价值。结果全组患者1、3、5年生存率分别为67.8%、28.7%和18.8%。其中术前TACE组1、3、5年生存率分别为74.7%、41.4%和36.9%,术后TACE组1、3、5年生存率分别为78.9%、40.4%和37.5%;TACE RFA组的近期有效率为93.4%,1、3年生存率分别为74.5%和36.8%;TACE组的近期有效率为83.2%,1、3、5年生存率分别为69.3%、21.7%和8.4%;TAI治疗的近期有效率为27.5%,1、3年生存率分别为11.6%和0。TACE RFA组和TACE组间肝功能Child降级、瘤内与瘤周血流信号消失和甲胎蛋白转阴率差异均无统计学意义,TACE RFA组、TACE组与TAI组肝功能Child降级差异无统计学意义。结论原发性肝癌手术切除前后TACE效果最佳,手术前与手术后行TACE疗效相近;TACE RFA疗效优于TACE;TAI疗效较差。     

Microwave ablation is as effective as radiofrequency ablation for very-early-stage hepatocellular carcinoma

Background: Percutaneous radiofrequency ablation (RFA) is a first-line treatment for very-early-stage hepatocellular carcinoma (HCC), whereas the efficacy of percutaneous microwave ablation (MWA) for very-early-stage HCC remains unclear. The purpose of this study was to clarify this issue by comparing the safety and efficacy of percutaneous MWA with percutaneous RFA in treating very-early-stage HCC. Methods: Clinical data of 460 patients who were diagnosed with very-early-stage HCC and treated with percutane-ous MWA or RFA between January 2007 and July 2012 at the Eastern Hepatobiliary Surgery Hospital, The Second Mili-tary Medical University, in Shanghai, China were retrospectively analyzed. Of these 460 patients, 159 received RFA, 301 received MWA. Overall survival (OS), recurrence-free survival (RFS), local tumor progression (LTP), complete ablation, and complication occurrence rates were compared between the two groups, and the prognostic factors associated with survival were analyzed. Results: No significant differences were observed between the two groups in terms of the 1-, 3-, or 5-year OS rates (99.3%, 90.4%, and 78.3% for MWA vs. 98.7%, 86.8%, and 73.3% for RFA, respectively;P= 0.331). Furthermore, no signif-icant differences were observed between the two groups in terms of the corresponding RFS rates (94.4%, 71.8%, and 46.9% for MWA vs. 89.9%, 67.3%, and 54.9% for RFA, respectively;P= 0.309), the LTP rates (9.6% vs. 10.1%,P= 0.883), the complete ablation rates (98.3% vs. 98.1%,P= 0.860), or the occurrence rates of major complications (0.7% vs. 0.6%,P= 0.691). By multivariate analysis, LTP, antiviral therapy, and treatment of recurrence were independent risk fac-tors for OS (P < 0.001), and the alpha-fetoprotein level was an independent prognostic factor for RFS (P= 0.002). Conclusions: MWA is as safe and effective as RFA in treating very-early-stage HCC, supporting MWA as a first-line treatment option for this disease.     

Long-term outcome of percutaneous radiofrequency ablation in recurrent hepatocellular carcinoma after liver transplantation

Purpose: To investigate the long-term outcome and prognostic factors of radiofrequency ablation (RFA) in recurrent hepatocellular carcinoma (HCC) after liver transplantation (LT).

Methods: From 2004 to 2014, 15 patients with 23 hepatic recurrent HCCs after LT underwent ultrasound-guided percutaneous RFA. There were 14 males and 1 female aged 54.3?±?9.5?years old (37–78?years old). The average tumour size was 3.3?±?1.2?cm (1.7–6.0?cm). Seven patients had a single HCC and eight had 2–4 HCCs. Regular follow-up after RFA was performed to assess local response rates and long-term survival rates. Survival results were generated using Kaplan–Meier estimates, and a multivariate analysis was performed using the Cox regression model.

Results: The technical success rate was 95.7% (22/23 tumours). The minor complication rate was 7.7% (2/26 sessions), and there were no major complications. The follow-up period was 27.4?±?18.9?months (12–116?months). The local progression rate and intrahepatic new lesion rate were 13.0% (3/23 tumours) and 53.3% (8/15 patients), respectively. Extrahepatic metastasis was found in four patients (26.7%). The 1-, 3- and 5-year estimated overall survival rates were 71.8%, 35.9% and 26.9%, respectively. Additionally, the multivariate analysis revealed that serum α-fetoprotein (AFP) before RFA, tumour number and extrahepatic metastasis were significantly related to overall survival after RFA.

Conclusion: Ultrasound-guided percutaneous RFA of recurrent HCC after LT had a high technical success rate and local control. However, RFA cannot decrease the frequency of new tumours or extrahepatic metastasis. The AFP level and tumour number before RFA should be considered to predict the outcome.     

射频消融及125I粒子植入在预防肝癌切除术后局部复发的作用

目的探讨降低原发性肝癌切除术后局部复发的方法,提高肝癌患者的长期生存率。方法78例肿瘤靠近第一、第二肝门,估计切缘距肿瘤<1cm的肝癌患者,按就诊单双日分为单纯切除组和联合组。单纯切除组38例,仅行常规肝癌切除;联合组40例,在肝癌切除后,切缘行射频消融和~(125)I粒子植入。全部患者术后均定期随访。结果联合组术后1、3、5年肿瘤复发率分别为7.5%、30.0%和45.0%,术后1、3、5年生存率分别为92.5%、67.5%和30.0%,与单纯切除组比较,其中3、5年复发率差异有统计学意义((x~2=7.340,P<0.01;x~2=15.740,P<0.01);联合组的3、5年生存率较单纯切除组呈现明显升高的趋势。结论肝癌切除后切缘射频消融和~(125)I粒子植入能有效地降低术后局部复发率,提高治疗效果,且有可能延长肝癌患者的生存期。     

Prognostic significance of systemic immune-inflammation index-based nomogram for early stage hepatocellular carcinoma after radiofrequency ablation

BackgroundRadiofrequency ablation (RFA) is the recommended treatment for early stage hepatocellular carcinoma (HCC), and the prognostic value of systemic immune-inflammation index (SII) in early stage HCC is not discussed. Therefore, the purpose of the study is to explore the prognostic value of SII based on lymphocyte, neutrophil, and platelet counts in patients with HCC after RFA.MethodsWe retrospectively evaluated the prognostic value of the SII in training and validation cohorts, and then established an effective nomogram for HCC after RFA based on SII. The C-index, and area under the time-dependent receiver operating characteristic curve (t-AUC) were used to evaluate the discrimination and calibration value of the nomogram.ResultsAn optimal cut-off value for the SII of 324.55×10⁹ stratified the patients with HCC into high- and low-SII groups. Univariate and multivariate analyses revealed that SII was an independent predictor for overall survival (OS) and recurrence-free survival (RFS). Moreover, SII was an independent prognostic factor for early-stage HCC with normal alpha-fetoprotein (AFP) levels. The t-AUC of the SII was higher for OS and RFS than for neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR). A high preoperative SII was associated with multiple tumors, larger tumors, and higher levels of AFP. A well-discriminated and calibrated nomogram was constructed to predict the probability of 1-, 2-, 3-, and 5-year RFS with C-indexes of 0.80, which was significantly higher than that obtained with other prognostic clinical indexes.ConclusionsThe SII is an independent prognostic factor affecting the survival outcomes of patients with early-stage HCC. The comprehensive nomogram based on SII presented in this study is a promising model for predicting RFS in HCC patients after RFA.     

Debulking treatment with CT-guided percutaneous radiofrequency ablation and hepatic artery infusion of floxuridine improves survival of patients with unresectable pulmonary and hepatic metastases of colorectal cancer

The survival of most patients with both unresectable hepatic and pulmonary metastases of colorectal cancer is poor. In this retrospective study, we investigated the efficacy of computed tomography （CT）-guided radiofrequency ablation （RFA） and systemic chemotherapy plus hepatic artery infusion of floxuridine （HAI-FUDR）. Sixty-one patients were selected from 1,136 patients with pulmonary and hepatic metastases from colorectal cancer. Patients were treated with RFA and systemic chemotherapy plus HAI-FUDR （ablation group, n=39） or systemic chemotherapy plus HAI-FUDR （FUDR group, n=22）. Patients in the two groups were matched by sex, age, number of metastases, and calendar year of RFA or FUDR. Survival data were evaluated by using univariate and multivariate analyses. Clinical characteristics were comparable between the two groups. Al patients in the ablation group underwent RFA and chemotherapy. Median fol ow-up was 56.8 months. The 1-, 3-, and 5-year overall survival （OS） rates were 97%, 64%, and 37%, respectively, for the ablation group, and 82%, 32%, and 19%, respectively, for the FUDR group. The 1-, 3-, and 5-year survival rates after metastasis were 97%, 49%, and 26%for the ablation group, and 72%, 24%, and 24%for the FUDR group, respectively. The median OS times were 45 and 25 months for the ablation and FUDR groups, respectively. In the multivariate analysis, treatment al ocation was a favorable independent prognostic factor for OS （P = 0.001） and survival after metastasis （P = 0.009）. These data suggest that the addition of RFA to systemic chemotherapy plus HAI-FUDR improves the survival of patients with both unresectable hepatic and pulmonary metastases from colorectal cancer.     

Radiofrequency ablation versus surgical resection for hepatocellular carcinoma within the Milan criteria: A study of 281 Western patients

Abstract

Objectives: The aim of this study was to compare survival between radiofrequency ablation (RFA) and surgical resection (SR) in patients with hepatocellular carcinoma (HCC) within Milan criteria. Methods: From January 2004 to December 2013 we consecutively and retrospectively included all patients with first occurrence of HCC within Milan criteria receiving SR or RFA as first-line treatment. The cumulative overall survival (OS) and disease-free survival (DFS) were compared after inverse probability weighting (including confounding factor). Results: A total of 281 patients (RFA 178, SR 103) were enrolled. In multivariate Cox regression RFA and SR were not independent predictors of survival or recurrence. The respective weighted 5 years OS and DFS for patients with propensity scores between 0.1–0.9 in the SR and RFA groups were 54–33% and 60–16.9%, P?=?0.695 and P?=?0.426, respectively. Local tumour progression rate did not differ according to treatment (P?=?0.523). Major complication rate was higher in the SR group, P?=?0.001. Hospitalisation duration was lower in the RFA group (mean 2.19 days, range 2–7) than in the SR group (mean 10.2 days, range 3–30), P?<?0.001. Conclusion: This large Western study has shown that OS and DFS did not differ after RFA (using mainly multipolar devices) and SR, for HCC within the Milan criteria in a European population, with a shorter hospitalisation time and a lower complication rate for RFA.     

Analysis of clinical outcomes and prognostic factors in 109 patients with early-stage non-small cell lung cancer treated with stereotactic ablation radiotherapy

Objective To evaluate the long-term survival and identify prognostic factors of patients diagnosed with early-stage non-small cell lung cancer (ES-NSCLC) receiving stereotactic ablation radiotherapy (SABR). Methods Clinical data of 109 ES-NSCLC patients treated with SABR in Henan Cancer Hospital from 2011 to 2018 were retrospectively analyzed. The overall survival (OS), cancer-specific survival (CSS) and progression-free survival (PFS) were calculated by Kaplan-Meier method and log-rank test. Multivariate prognostic analysis was performed by Cox regression model. Results The median follow-up time was 44 months (2-93 months). The median OS, CSS and PFS were 78 months, 78 months and 44 months, respectively. The 1-year OS, CSS and PFS were 95.4%, 97.2% and 84.1%, and 75.6%, 79.1% and 56.6% for the 3-year OS, CSS and PFS, and 55.6%, 60.7% and 37.3% for the 5-year OS, CSS and PFS, respectively. Univariate analysis showed that ECOG score, age, smoking history and derived-neutrophil/lymphocyte ratio (dNLR) were the influencing factors of OS (P=0.03, 0.02, 0.04, 0.001). Age, smoking history and dNLR were the influencing factors of CSS (P=0.02, 0.03, 0.001). Multivariate analysis demonstrated that dNLR was an independent prognostic factor for OS and CSS (P=0.001, 0.001). Conclusions ES-NSCLC patients treated with SABR can achieve favorable survival. The dNLR is an independent prognostic factor of OS and CSS, which can be considered in clinical application.     

Stereotactic radiofrequency ablation as first-line treatment of recurrent HCC following hepatic resection

BackgroundTo evaluate the therapeutic efficacy, safety and overall clinical outcome of multiprobe stereotactic RF ablation (SRFA) as first-line treatment of HCC recurrence after hepatic resection (HR).Study designIn this retrospective single-center study, 34 consecutive patients with previous HR were treated by SRFA between 2006 and 2018 for 140 HCCs in 60 ablation sessions.ResultsThe median treated tumor size was 3.0 cm (range 0.5–10 cm). SRFA was primarily successful for 133/140 (95%) tumors. Four tumors were successfully retreated, resulting in a secondary technical efficacy rate of 97.9%. Local tumor recurrence developed in 4 of 140 tumors (2.9%). The major complication rate was 4.8% (3 of 60 ablations). No periprocedural deaths occurred.The overall survival (OS) rates at 1-, 3-, and 5- years from the date of the first SRFA were 94.0%, 70.2%, and 53.3%, respectively, with a median OS of 69.1 months (95% CI 18.8–119.3). The disease-free survival (DFS) was 52.6%, 19.7% and 15.8%, at 1-, 3- and 5- years, respectively, with a median DFS of 12.8 months (95% CI 9.0–28.9).ConclusionStereotactic RFA is a safe, feasible and useful option in the management of recurrent HCC following HR with low morbidity paired with good clinical outcome.