Computed Tomography-Guided Percutaneous Cryoablation for Subcardiac Hepatocellular Carcinoma: Safety, Efficacy, Therapeutic Results and Risk Factors for Survival Outcomes
Authors Qi C, Gao H, Zhao Q, Zhang L
Received 20 February 2020
Accepted for publication 23 April 2020
Published 12 May 2020 Volume 2020:12 Pages 3333—3342
Checked for plagiarism Yes
Review by Single-blind
Peer reviewer comments 2
Editor who approved publication: Dr Eileen O'Reilly
Chunhou Qi,1 Hongfei Gao,1 Qinghua Zhao,2 Lei Zhang3
1Department of Interventional Medicine, Linyi City Central Hospital, Yishui, Shandong, People’s Republic of China; 2Department of Emergency Medicine, Yishui County People’s Hospital, Yishui, Shandong, People’s Republic of China; 3Department of Interventional Radiology, Shandong Medical Imaging Research Institute, Affiliated to Shandong University, Jinan, Shandong, People’s Republic of China
Correspondence: Lei Zhang
Department of Interventional Radiology, Shandong Medical Imaging Research Institute, Affiliated to Shandong University, 324 Jingwu Road, Jinan, Shandong, People’s Republic of China
Objective: To investigate the clinical safety, efficacy, therapeutic outcomes and risk factors of computed tomography-guided percutaneous cryoablation (CT-PCRA) for subcardiac hepatocellular carcinoma (HCC).
Patients and Methods: In this study, patients with single HCC nodules located on the left lobe who subsequently underwent CT-PCRA were reviewed from July 2012 to August 2016. According to the definition of subcardiac HCC, the patients were grouped into the subcardiac HCC group (n=33) and the non-subcardiac HCC group (n=40). The technical success rates, tumour response rates, oncological outcomes including overall survival (OS) and recurrence-free survival (RFS) and complications were compared. Multivariate analysis was performed on clinicopathological variables to identify factors affecting long-term outcomes.
Results: Seventy-three patients with subcardiac HCC were included in this study. After a median follow-up time of 37.8 months, 27.4% (20/73) of the patients died. The technical success and complete response rates were not significantly different between the two groups (p = 1.000; p = 0.590). The cumulative OS and RFS of the subcardiac HCC group were comparable to those of the non-subcardiac HCC group (p =0.820, p =0.922). Two major complications, intra-abdominal bleeding and right pleural effusion, were found at 2.2 and 3.1 months in the subcardiac HCC group, which were comparable with those in the non-subcardiac HCC group (p = 0.683). The multivariate analysis results showed that older age (hazard ratio [HR]: 2.382, 95% confidence interval [CI]: 1.884– 7.823; p = 0.038) and ALBI grade 2– 3 (HR: 3.398, 95% CI: 1.950– 6.058; p = 0.021) may be predictors of poor OS and that tumour size ≥ 3 cm in diameter (HR: 3.302, 95% CI: 2.232– 8.293; p = 0.012) may be a predictor of poor RFS.
Conclusion: CT-PCRA for subcardiac HCC can be performed safely and efficiently and contribute to improving survival prognosis.
Keywords: cryoablation, subcardiac location, hepatocellular carcinoma, therapeutic outcomes, risk factors
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