目的:可行性,研究了图像引导热消融治疗肝上皮样血管内皮瘤(HEHE)患者的安全性和临床结局.
方法:这是对2013年1月至2023年2月期间接受HEHE图像引导热消融的18例患者(43.9±14.8岁;6例男性)进行的多中心回顾性调查。总共评估了31个消融疗程(24个涉及微波消融,7个涉及射频消融)。技术成功率,评估并发症和结局.Kaplan-Meier方法用于评估无进展生存期(PFS)和总生存期(OS)率。采用Cox比例风险回归分析探讨影响PFS的危险因素。
结果:技术成功率为93.5%(29/31)。消融后无重大并发症发生。局部肿瘤进展发生在2个疗程(6.5%,2/31)消融后,肝内远处转移发生在16个疗程(51.6%,16/31)。在37.2个月的中期随访时间内(范围,3-117个月),OS和PFS率分别为87.6%和62.2%,分别,一年;75.5%和37.4%,分别,3年;75.5%和37.4%,分别,在5年。中位OS和PFS分别为90.5个月(95%CI:68.1,112.8)和23.8个月(95%CI:15.4,32.2),分别。根据多变量分析,较大的肿瘤大小(P=0.026)与较短的PFS相关。
结论:图像引导热消融是HEHE患者的一种可行且安全的治疗选择,可获得良好的局部肿瘤控制和良好的长期预后。
OBJECTIVE: To investigate the feasibility, safety, and clinical outcomes of image-guided thermal ablation in patients with hepatic epithelioid hemangioendothelioma (HEHE).
METHODS: This was a multicenter retrospective investigation of 18 patients (43.9 years [SD ± 14.8]; 6 men) who underwent image-guided thermal ablation for HEHE between January 2013 and February 2023. A total of 31 ablation sessions (24 involving microwave ablation and 7 involving radiofrequency ablation) were evaluated. The rates of technical success, adverse events, and outcomes were assessed. The Kaplan‒Meier method was used to estimate progression-free survival (PFS) and overall survival (OS) rates. The risk factors affecting PFS were investigated using Cox proportional hazard regression analysis.
RESULTS: The technical success rate was 93.5% (29/31). No major adverse events occurred. Local tumor progression occurred after 2 sessions (6.5%, 2/31), and intrahepatic distant metastasis occurred after 16 sessions (51.6%, 16/31). During the medium follow-up time of 37.2 months (range, 3-117 months), the OS and PFS rates were 87.6% and 62.2%, respectively, at 1 year; 75.5% and 37.4%, respectively, at 3 years; and 75.5% and 37.4%, respectively, at 5 years. The median OS and PFS were 90.5 months (95% CI: 68.1-112.8) and 23.8 months (95% CI: 15.4-32.2), respectively. According to the multivariate analysis, a larger tumor size (P = .026) was associated with shorter PFS.
CONCLUSIONS: Image-guided thermal ablation is a feasible and safe treatment option for patients with HEHE that resulted in local tumor control and a favorable long-term prognosis.