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Cai Q, Qian TG, Zhao QY, Feng SY, Yang Q, Luo YC, Dai YQ, Liang P, Yu XL, Liu FY, Han ZY, Du QW, Li X, Yu J. Percutaneous microwave ablation versus sclerotherapy for large hepatic hemangioma: a multi-center cohort study. Int J Hyperthermia 2024; 41:2285705. [PMID: 38269491 DOI: 10.1080/02656736.2023.2285705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 11/15/2023] [Indexed: 01/26/2024] Open
Abstract
OBJECTIVE The study aimed to compare the effectiveness and safety of ultrasound-guided microwave ablation (MWA) and percutaneous sclerotherapy (PS) for the treatment of large hepatic hemangioma (LHH). METHODS This retrospective study included 96 patients who underwent MWA (n = 54) and PS (n = 42) as first-line treatment for LHH in three tertiary hospitals from January 2016 to December 2021. Primary outcomes were technique efficacy rate (volume reduction rate [VRR] > 50% at 12 months), symptom relief rate at 12 months and local tumor progression (LTP). Secondary outcomes included procedure time, major complications, treatment sessions, cost and one-, two-, three-year VRR. RESULTS During a median follow-up of 36 months, the MWA group showed a higher technique efficacy rate (100% vs. 90.4%, p = .018) and symptom relief rate (100% vs. 80%, p = .123) than the PS group. The MWA group had fewer treatment sessions, higher one-, two- and three-year VRR, lower LTP rate (all p < .05), longer procedure time and higher treatment costs than the PS group (both p < .001). MWA shared a comparable major complications rate (1.8% vs. 2.4%, p = .432) with PS. After multivariate analysis, the lesion's heterogeneity and maximum diameter >8.1 cm were independent risk factors for LTP (all p < .05). In the PS group, lesions with a cumulative dose of bleomycin > 0.115 mg/cm3 had a lower risk of LTP (p = .006). CONCLUSIONS Both MWA and PS treatments for large hepatic hemangioma are safe and effective, with MWA being superior in terms of efficacy.
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Affiliation(s)
- Qian Cai
- Department of Interventional Ultrasound, Fifth Medical Center of Chinese PLA General Hospital & Chinese PLA Medical College, Beijing, China
| | - Tong-Gang Qian
- Department of Ultrasound, Zunhua People's Hospital, Zunhua, China
| | - Qi-Yu Zhao
- Department of Ultrasound, Zhejiang University School of Medicine & the First Hospital of Zhejiang Province, Hangzhou, China
| | - Shun-You Feng
- Department of Ultrasound, Zunhua People's Hospital, Zunhua, China
| | - Qiao Yang
- Department of Ultrasound, Zunhua People's Hospital, Zunhua, China
| | - Yan-Chun Luo
- Department of Interventional Ultrasound, Fifth Medical Center of Chinese PLA General Hospital & Chinese PLA Medical College, Beijing, China
| | - Yu-Qing Dai
- Department of Interventional Ultrasound, Fifth Medical Center of Chinese PLA General Hospital & Chinese PLA Medical College, Beijing, China
| | - Ping Liang
- Department of Interventional Ultrasound, Fifth Medical Center of Chinese PLA General Hospital & Chinese PLA Medical College, Beijing, China
| | - Xiao-Ling Yu
- Department of Interventional Ultrasound, Fifth Medical Center of Chinese PLA General Hospital & Chinese PLA Medical College, Beijing, China
| | - Fang-Yi Liu
- Department of Interventional Ultrasound, Fifth Medical Center of Chinese PLA General Hospital & Chinese PLA Medical College, Beijing, China
| | - Zhi-Yu Han
- Department of Interventional Ultrasound, Fifth Medical Center of Chinese PLA General Hospital & Chinese PLA Medical College, Beijing, China
| | - Qiao-Wei Du
- Department of Interventional Ultrasound, Fifth Medical Center of Chinese PLA General Hospital & Chinese PLA Medical College, Beijing, China
| | - Xin Li
- Department of Interventional Ultrasound, Fifth Medical Center of Chinese PLA General Hospital & Chinese PLA Medical College, Beijing, China
| | - Jie Yu
- Department of Interventional Ultrasound, Fifth Medical Center of Chinese PLA General Hospital & Chinese PLA Medical College, Beijing, China
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Zhou QQ, Hu YB, Zhou K, Zhang WW, Li MH, Dong P, Di JG, Hong L, Du QW, Xie Y, Sun QF. [Value of non-invasive models of liver fibrosis in judgment of treatment timing in chronic hepatitis B patients with ALT < 2×upper limit of normal]. Zhonghua Gan Zang Bing Za Zhi 2017; 24:665-670. [PMID: 27788722 DOI: 10.3760/cma.j.issn.1007-3418.2016.09.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To investigate the value of non-invasive liver fibrosis models, FIB-4, S index, aspartate aminotransferase to platelet ratio index(APRI), globulin-platelet(GP)model, aspartate aminotransferase/platelet/gamma-glutamyl transpeptidase/alpha-fetoprotein(APGA), and platelet/age/phosphatase/alpha-fetoprotein/aspartate aminotransferase(PAPAS), in the diagnosis of marked liver fibrosis in chronic hepatitis B(CHB)patients with ALT < 2×upper limit of normal(ULN), as well as treatment timing for this population. Methods: A total of 389 CHB patients with ALT < 2×ULN who were admitted to Beijing Ditan Hospital and whose treatment timing was difficult to judge were enrolled. Transdermal liver biopsy was performed to obtain pathological results, and routine serological tests were performed, including routine blood test, serum biochemical parameters, hepatitis B virus(HBV)markers, and HBV DNA. According to liver pathology, the patients were divided into non-marked liver fibrosis group(S < 2)with 324 patients and marked liver fibrosis group(S≥2)with 65 patients. The non-invasive models for predicting liver fibrosis was established with reference to original articles. SPSS 19.0 software was used for statistical analysis, and the receiver operating characteristic(ROC)curve was used to compare the value of different non-invasive models in predicting marked liver fibrosis in this population. Results: All the non-invasive models had a certain diagnostic value for liver fibrosis degree in these patients, and the areas under the ROC curve for APRI, FIB-4, APGA, S index, PAPAS, and GP model were 0.718, 0.691, 0.758, 0.729, 0.673, and 0.691, respectively. APGA had the largest area under the ROC curve(0.758, 95% CI 0.673-0.844), and gamma-glutamyl transpeptidase was significantly positively correlated with liver fibrosis degree. Conclusion: The non-invasive models of liver fibrosis can identify marked liver fibrosis in CHB patients with ALT < 2×ULN in whom it is difficult to judge treatment timing and help to determine treatment timing for them. APGA model has the highest value and can reduce the need for liver biopsy to the certain degree.
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Affiliation(s)
- Q Q Zhou
- Department of Infectious Diseases, Ruian People's Hospital, Wenzhou 325200, China
| | - Y B Hu
- Wenzhou Medical University, Wenzhou 325035, China
| | - K Zhou
- Department of Infectious Diseases, Ruian People's Hospital, Wenzhou 325200, China
| | - W W Zhang
- Department of Infectious Diseases, Ruian People's Hospital, Wenzhou 325200, China
| | - M H Li
- Liver Center of Beijing Ditan Hospital, Capital Medical University, Beijing 100015, China
| | - P Dong
- Department of Infectious Diseases, Ruian People's Hospital, Wenzhou 325200, China
| | - J G Di
- Department of Infectious Diseases, Ruian People's Hospital, Wenzhou 325200, China
| | - L Hong
- Department of Infectious Diseases, Ruian People's Hospital, Wenzhou 325200, China
| | - Q W Du
- Department of Infectious Diseases, Ruian People's Hospital, Wenzhou 325200, China
| | - Y Xie
- Liver Center of Beijing Ditan Hospital, Capital Medical University, Beijing 100015, China
| | - Q F Sun
- Department of Infectious Diseases, Ruian People's Hospital, Wenzhou 325200, China
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