Background: Several locoregional treatments approaches, including thermoablation, have been tested for the treatment of intrahepatic cholangiocarcinoma (ICC) and have shown encouraging results. However, data are heterogeneous in terms of tumor number, size, and ablation technique. Objective: The aim of this study was to investigate the efficacy and prognostic factors in ICC treated by monopolar radiofrequency (RF) or microwave ablation (MW). Methods: This was a retrospective study including patients treated with RF or MW for ICC in six participating centers. DFS and OS were evaluated by the Kaplan–Meier method and prognostic factors by log-rank test and Cox modeling. Results: From January 2015 to October 2023, 24 patients with 31 nodules were treated with RFA or MW. Overall, 70% had chronic liver disease, with 50% at cirrhosis stage. The median size of lesions was 17 mm (6–35 mm). After a median follow-up of 33 months (5–85), the median DFS was 10.5 months. The median OS was 40.8 months. On univariate and multivariate analysis, only lesion size > 17 mm was associated with a poor OS (HR 3.09; IC [1.02; 9.37] (p= 0.04). Conclusions: Monopolar radiofrequency or microwave ablation is an alternative to surgery for small ICCs. Tumors < 17 mm were associated with better OS.
背景：针对肝内胆管癌（ICC）的治疗，包括热消融在内的多种局部区域治疗方法已得到验证，并显示出令人鼓舞的疗效。然而，现有数据在肿瘤数量、大小及消融技术方面存在异质性。目的：本研究旨在探讨单极射频（RF）或微波消融（MW）治疗ICC的疗效及预后影响因素。方法：本研究为一项回顾性研究，纳入了六家参与中心接受RF或MW治疗的ICC患者。采用Kaplan-Meier法评估无病生存期（DFS）和总生存期（OS），并通过log-rank检验和Cox模型分析预后因素。结果：2015年1月至2023年10月期间，共有24例患者（31个结节）接受了RFA或MW治疗。总体而言，70%的患者患有慢性肝病，其中50%已进展至肝硬化阶段。病灶中位大小为17毫米（范围6-35毫米）。中位随访33个月（范围5-85个月）后，中位DFS为10.5个月，中位OS为40.8个月。单因素及多因素分析显示，仅病灶大小>17毫米与较差的OS相关（风险比3.09；置信区间[1.02; 9.37]；p=0.04）。结论：对于小型ICC，单极射频或微波消融可作为手术的替代治疗方案。肿瘤大小<17毫米与更好的总生存期相关。
肿瘤(癌症)患者之家