Abstract

Purpose

To assess the safety and efficacy of a two-step single-session procedure, combining transarterial embolization (TAE) and percutaneous microwave ablation (MWA), in the treatment of > 3 cm unresectable liver metastases. We also compared the final volume obtained by the two techniques (V_E-T) and the expected ablation volume of the stand-alone MWA (V_T).

Methods

From January 2015 to December 2017, 22 consecutive patients, with a total of 24 unresectable hepatic metastases >3 cm in diameter underwent a two-step single-session combined treatment of TAE and MWA. Follow-up computed tomography scans were performed at 1-, 3-, 6-, 12, and 24 months post-procedure. V_E-T as final ablation volume induced by the combined treatment (TAE-MWA), V_N as initial nodule volume, V_T as expected ablation volume of MWA treatment alone were evaluated and compared.

Results

Tumor dimensions ranged from 32 to 73 mm. Technical success was achieved in all treated tumors with no local tumor recurrence. Final ablation volumes ranged from 50 to 450 cm³ and the short-axis diameter of the ablation zone ranged from 12 to 48 mm. The mean ΔV increment in the final ablation volume with respect to the stand-alone MWA was 196% (ranging from 25 cm³ − 210 cm³) (p < 0.05). The V_E-T mean was four times the V_N mean, while the V_T mean was about twice the V_N mean. No recurrence and only one case of post-embolization bleeding were observed.

Conclusions

This study demonstrated the safety and efficacy of a combined two-step single-session TAE-MWA treatment of unresectable hepatic metastases > 3 cm in diameter.

中文翻译：

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联合动脉栓塞和微波消融术治疗无法切除的大肝转移（最大直径> 3 cm）

摘要

目的

为了评估两步单次治疗的安全性和有效性，结合经动脉栓塞术（TAE）和经皮微波消融术（MWA），用于治疗> 3 cm不可切除的肝转移。我们还比较了通过两种技术获得的最终体积（V _E-T）和独立MWA的预期消融体积（V _T）。

方法

从2015年1月至2017年12月，对连续22例直径24毫米（> 3厘米）的不可切除的肝转移患者进行了两步单次联合治疗TAE和MWA。术后1、3、6、12和24个月进行了计算机断层扫描。评估并比较了联合治疗（TAE-MWA）诱导的最终消融量V _E-T ，初始结节体积V _N ，单独的MWA治疗的预期消融量V _T。

结果

肿瘤尺寸为32至73mm。在所有没有局部肿瘤复发的治疗肿瘤中都取得了技术上的成功。最终消融体积为50至450 cm ³，消融区的短轴直径为12至48 mm。在最终的消融体积的平均增量ΔV相对于所述独立MWA为196％（范围从25厘米³ - 210厘米³）（p  <0.05）。V _E-T平均值是V _N平均值的四倍，而V _T平均值约为V _N平均值的两倍。无复发，仅观察到一例栓塞后出血。

结论

这项研究证明了联合使用的两步单次TAE-MWA联合治疗直径大于3 cm的不可切除的肝转移的安全性和有效性。