Purpose: Hepatic Arteriography and C-Arm CT-Guided Ablation of liver tumors (HepACAGA) is a novel technique, combining hepatic–arterial contrast injection with C-arm CT-guided navigation. This study compared the outcomes of the HepACAGA technique with patients treated with conventional ultrasound (US) and/or CT-guided ablation. Materials and Methods: In this retrospective cohort study, all consecutive patients with hepatocellular carcinoma (HCC) or colorectal liver metastases (CRLM) treated with conventional US-/CT-guided ablation between 1 January 2015, and 31 December 2020, and patients treated with HepACAGA between 1 January 2021, and 31 October 2023, were included. The primary outcome was local tumor recurrence-free survival (LTRFS). Secondary outcomes included the local tumor recurrence (LTR) rate and complication rate. Results: 68 patients (120 tumors) were included in the HepACAGA cohort and 53 patients (78 tumors) were included in the conventional cohort. In both cohorts, HCC was the predominant tumor type (63% and 73%, respectively). In the HepACAGA cohort, all patients received microwave ablation. Radiofrequency ablation was the main ablation technique in the conventional group (78%). LTRFS was significantly longer for patients treated with the HepACAGA technique (p= 0.015). Both LTR and the complication rate were significantly lower in the HepACAGA cohort compared to the conventional cohort (LTR 5% vs. 26%, respectively;p< 0.001) (complication rate 4% vs. 15%, respectively;p= 0.041). Conclusions: In this study, the HepACAGA technique was safer and more effective than conventional ablation for HCC and CRLM, resulting in lower rates of local tumor recurrence, longer local tumor recurrence-free survival and fewer procedure-related complications.
目的：肝动脉造影联合C臂CT引导肝肿瘤消融术（HepACAGA）是一种将肝动脉造影与C臂CT导航相结合的新型技术。本研究旨在比较HepACAGA技术与传统超声（US）和/或CT引导消融术的临床疗效。 材料与方法：本回顾性队列研究纳入了2015年1月1日至2020年12月31日期间接受传统US/CT引导消融治疗的所有连续肝细胞癌（HCC）或结直肠癌肝转移（CRLM）患者，以及2021年1月1日至2023年10月31日期间接受HepACAGA治疗的患者。主要研究终点为局部肿瘤无复发生存期（LTRFS）。次要研究终点包括局部肿瘤复发（LTR）率及并发症发生率。 结果：HepACAGA队列纳入68例患者（120个肿瘤），传统队列纳入53例患者（78个肿瘤）。两组中HCC均为主要肿瘤类型（分别占63%和73%）。HepACAGA队列所有患者均接受微波消融治疗，而传统队列主要采用射频消融技术（78%）。接受HepACAGA技术治疗的患者LTRFS显著延长（p=0.015）。与传统队列相比，HepACAGA队列的LTR率（5% vs. 26%，p<0.001）和并发症发生率（4% vs. 15%，p=0.041）均显著降低。 结论：本研究表明，对于HCC和CRLM的治疗，HepACAGA技术较传统消融术更为安全有效，具有更低的局部肿瘤复发率、更长的局部肿瘤无复发生存期及更少的操作相关并发症。
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