Ultrasound-guided percutaneous microwave ablation of seeding from hepatocellular carcinoma in thoracoabdominal wall

doi:10.3877/cma.j.issn.2095-5782.2019.04.002

Abstract

Abstract:

Objective:

The objective of the study is to evaluate the effectiveness and feasibility of ultrasound-guided percutaneous microwave ablation (MWA) in patients who occurred seeding from hepatocellular carcinoma (HCC) in thoracoabdominal wall.

Methods:

A total of 15 patients (13 men, 2 women; 57.2±17.6 years) with the seeding from HCC in thoracoabdominal wall, underwent US-guided percutaneous MWA and were included in the study from January 2007 to January 2017. We collect the population and tumor characteristics of the seeding. Local seeding progression (LSP) and overall survival (OS) are analyzed statistically with the log-rank test. Multivariate analysis are performed on clinico-pathological variables to identify factors affecting OS.

Results:

After a median follow-up time of 27.8 (3.8-67.2) months, cumulative 0.5-, 1-, 2-years LSP rate is 6.7%, 23.0% and 23.0%, respectively. And cumulative 1-, 3-, 5-years OS rate is 80.0%, 61.7%, and 46.3%, respectively. Multivariate analysis show that older age (P=0.006, HR=2.218, 95%CI=1.338-4.923) , poor control of intrahepatic lesion (P=0.002, HR=5.529, 95%CI=2.372-15.443) and poor pathological type (P=0.021, HR=2.782, 95%CI=1.035-4.112) are independently associated with OS.

Conclusions:

Ultrasound-guided percutaneous microwave ablation in the treatment of seeding from HCC in thoracoabdominal wall, which can produce satisfactory tumor outcomes, but the survival of patients depends mainly on the control of intrahepatic lesions.

Key words: Ultrasound, Microwave ablation, Hepatocellular carcinoma, Seeding, Thoracoabdominal wall

Chao An, Jie Yu, Xiaoling Yu, Zhigang Cheng, Zhiyu Han, Fangyi Liu, Ping Liang. Ultrasound-guided percutaneous microwave ablation of seeding from hepatocellular carcinoma in thoracoabdominal wall[J]. Chinese Journal of Interventional Radiology(Electronic Edition), 2019, 07(04): 273-277.

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References 15

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序号	性别	年龄（岁）	转移灶直径（cm）	数量（个）	肝炎	病理分型	位置	种植时间（月）	生存时间（月）
1	男	65	4.5	1	乙肝	中分化	腹壁	17.7	36.8
2	男	58	6.4	1	乙肝	中分化	腹壁	4.2	74.2
3	男	67	3.5	1	乙肝	中分化	腹壁	17.5	52.6
4	男	59	6.3	1	乙肝	高分化	腹壁	6.3	14.7
5	男	48	2.7	2	乙肝	中分化	胸壁	22.1	37.5
6	男	61	4.9	1	乙肝	高分化	腹壁	12.0	32.4
7	男	71	4.0	1	丙肝	中分化	腹壁	30.5	54.2
8	男	66	3.7	1	乙肝	中分化	腹壁	37.9	49.0
9	男	41	2.9	1	乙肝	中分化	胸壁	34.3	44.7
10	女	47	3.3	2	乙肝	高分化	腹壁	12.2	53.5
11	女	72	4.7	1	乙肝	高分化	腹壁	15.6	22.9
12	男	78	2.0	1	乙肝	高分化	腹壁	24.0	35.6
13	男	51	2.3	1	乙肝	高分化	胸壁	30.8	43.2
14	男	48	2.5	1	丙肝	中分化	胸壁	17.8	67.3
15	男	61	2.5	1	乙肝	高分化	胸壁	28.0	58.9

序号	性别	年龄（岁）	转移灶直径（cm）	数量（个）	肝炎	病理分型	位置	种植时间（月）	生存时间（月）
1	男	65	4.5	1	乙肝	中分化	腹壁	17.7	36.8
2	男	58	6.4	1	乙肝	中分化	腹壁	4.2	74.2
3	男	67	3.5	1	乙肝	中分化	腹壁	17.5	52.6
4	男	59	6.3	1	乙肝	高分化	腹壁	6.3	14.7
5	男	48	2.7	2	乙肝	中分化	胸壁	22.1	37.5
6	男	61	4.9	1	乙肝	高分化	腹壁	12.0	32.4
7	男	71	4.0	1	丙肝	中分化	腹壁	30.5	54.2
8	男	66	3.7	1	乙肝	中分化	腹壁	37.9	49.0
9	男	41	2.9	1	乙肝	中分化	胸壁	34.3	44.7
10	女	47	3.3	2	乙肝	高分化	腹壁	12.2	53.5
11	女	72	4.7	1	乙肝	高分化	腹壁	15.6	22.9
12	男	78	2.0	1	乙肝	高分化	腹壁	24.0	35.6
13	男	51	2.3	1	乙肝	高分化	胸壁	30.8	43.2
14	男	48	2.5	1	丙肝	中分化	胸壁	17.8	67.3
15	男	61	2.5	1	乙肝	高分化	胸壁	28.0	58.9

指标	β	SE	Wald χ²	P	OR	OR 95%CI
年龄	1.568	0.537	10.850	0.006	2.118	1.338~4.923
肝内病灶控制	1.854	0.483	13.590	0.002	5.529	2.372~15.443
病理分型	1.308	0.575	3.940	0.021	2.782	1.035~4.112

指标	β	SE	Wald χ²	P	OR	OR 95%CI
年龄	1.568	0.537	10.850	0.006	2.118	1.338~4.923
肝内病灶控制	1.854	0.483	13.590	0.002	5.529	2.372~15.443
病理分型	1.308	0.575	3.940	0.021	2.782	1.035~4.112

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