Abstract

Objective

To investigate the risk factors affecting the technical failure of artificial ascites (AA) formation and to evaluate the local control efficacy of percutaneous thermal ablation assisted by the AA for hepatic tumors.

Methods

A total of 341 patients with 362 hepatic tumors who underwent thermal ablation assisted by AA were reviewed retrospectively. The technical success of AA, the volume of liquid, and local efficacy after ablation were assessed. Predictive factors for the technical failure of AA formation and local tumor progression (LTP) were analyzed using univariate and multivariate analysis.

Results

The technical success rate of AA formation was 81.8% (296/362). The amount of fluid was higher when the tumor was located in the left lobe of the liver than when it was located in the right lobe (median 950 ml versus 700 ml, p < 0.001). Previous hepatic resection (OR: 12.63, 95% CI: 2.93–54.45, p < 0.001), ablation (OR: 6.48, 95% CI: 1.36–30.92, p = 0.019) and upper-abdomen surgery (OR: 11.34, 95% CI: 1.96–65.67, p = 0.007) were the independent risk factors of AA failure. In the AA success group, the complete ablation rate was higher and the LTP rate was lower than that in the AA failure group (98.7 versus 92.4%, p = 0.012; 8.8 versus 21.2%, p = 0.004). Multivariate analysis identified AA failure (p = 0.004), tumor size (>3.0 cm) (p = 0.002) and metastatic liver tumor (p = 0.008) as independent risk factors for LTP.

Conclusion

History of hepatic resection, ablation and upper abdomen surgery were significant predictive factors affecting the technical failure of AA formation. Successful introduction of AA before thermal ablation can achieve better local tumor control efficacy.

中文翻译：

---

肝肿瘤的经皮热消融：局部控制疗效和人工腹水衰竭的危险因素

摘要

客观的

调查影响人造腹水（AA）形成技术失败的危险因素，并评估AA辅助的经皮热消融治疗肝肿瘤的局部控制疗效。

方法

回顾性分析了341例362例肝肿瘤患者，在AA的辅助下进行了热消融。评估了AA的技术成功率，液体量和消融后的局部疗效。使用单变量和多变量分析来分析AA形成技术失败和局部肿瘤进展（LTP）的预测因素。

结果

AA形成的技术成功率为81.8％（296/362）。当肿瘤位于肝的左叶中时，其流体量要比其位于右叶中时的流体量高（中位950 ml对700 ml，p  <0.001）。先前的肝切除术（OR：12.63，95％CI：2.93–54.45，p  <0.001），消融（OR：6.48，95％CI：1.36–30.92，p  = 0.019）和上腹部手术（OR：11.34，95 CI的百分比：1.96-65.67，p  = 0.007）是AA失败的独立危险因素。在AA成功组中，完全消融率更高，LTP率低于AA失败组（98.7比92.4％，p  = 0.012； 8.8比21.2％，p = 0.004）。多变量分析确定AA失败（p  = 0.004），肿瘤大小（> 3.0 cm）（p  = 0.002）和转移性肝肿瘤（p  = 0.008）是LTP的独立危险因素。

结论

肝切除，消融和上腹部手术的历史是影响AA形成技术失败的重要预测因素。在热消融之前成功引入AA可以达到更好的局部肿瘤控制功效。