Local ablation therapies are important treatment options for early-stage hepatocellular carcinoma (HCC). Various techniques have been used to perform these therapies efficiently and safely. However, few reports have discussed the usefulness of body position change (BPC). This study aimed to investigate the usefulness of BPC during local ablation therapies in patients with HCC. We evaluated 283 HCC nodules that underwent local ablation therapy. These nodules were categorized into high- or low-risk locations on the basis of their proximity to large vessels, adjacent extrahepatic organs, or poor visibility under ultrasound (US) guidance. The technical success rates, procedure time, and prognosis were evaluated. In this study, 176 (62%) nodules were classified in the high-risk location group. The high-risk location group was treated with techniques such as BPC, artificial pleural fluid, artificial ascites, fusion imaging, and contrast-enhanced US more frequently than the low-risk location group. The technical success rates were 96% and 95% for the high- and low-risk location groups, respectively. Within the high-risk location group, those without BPC had a lower success rate than those with BPC (91% vs. 99%,p= 0.015). Notably, BPC emerged as the sole contributing factor to the technical success rate in the high-risk location group (OR = 10, 95% CI 1.2–86,p= 0.034). In contrast, no differences were found in the procedure time, local tumor progression rates, intrahepatic distant recurrence rates, and overall survival between the groups with and without BPC in the high-risk location group. In conclusion, BPC during local ablation therapy in patients with HCC in high-risk locations was safe and efficient. The body position should be adjusted for HCC in high-risk locations to maintain good US visibility and ensure a safe puncture route in patients undergoing local ablation therapies.
局部消融治疗是早期肝细胞癌（HCC）的重要治疗手段。为安全有效地实施此类治疗，临床上已应用多种技术，但关于体位改变（BPC）作用的探讨尚不充分。本研究旨在探讨BPC在HCC患者局部消融治疗中的应用价值。我们评估了接受局部消融治疗的283个HCC结节，根据其与大血管的邻近程度、毗邻肝外器官情况或超声引导下可视性，将结节分为高危位置组与低危位置组，并对技术成功率、手术时间及预后进行评估。结果显示，176个（62%）结节被归入高危位置组。与低危位置组相比，高危位置组更频繁地采用BPC、人工胸水、人工腹水、融合成像及超声造影等技术。高危位置组与低危位置组的技术成功率分别为96%和95%。在高危位置组中，未采用BPC的结节成功率低于采用BPC者（91% vs. 99%，p=0.015）。值得注意的是，BPC是影响高危位置组技术成功率的唯一独立因素（OR=10，95% CI 1.2–86，p=0.034）。然而，在高危位置组内，采用与未采用BPC的患者在手术时间、局部肿瘤进展率、肝内远处复发率及总生存率方面均无显著差异。综上所述，对于高危位置的HCC患者，在局部消融治疗中应用BPC安全有效。在实施局部消融治疗时，应通过调整体位以维持良好的超声可视性并确保安全的穿刺路径。
肿瘤(癌症)患者之家