Risk Factors and Prediction Nomogram of Local Regeneration after Ultrasound-guided Microwave Ablation of Uterine Fibroids.

STUDY OBJECTIVE: To explore the risk factors associated with local regeneration of the treated uterine fibroids (UFs) after microwave ablation (MWA) and to develop a nomogram model for predicting the risk of local regeneration. DESIGN: Retrospective study. SETTING: The Eighth Affiliated Hospital of Sun Yat-Sen University. PATIENTS: Patients with UFs who underwent MWA at our hospital between October 2020 and April 2023 were included. INTERVENTION: MWA was used for the treatment of UFs. MEASUREMENTS AND MAIN RESULTS: A total of 47 patients with 68 fibroids were included into this study. Over a median follow-up of 13 months (interquartile range, 8-22 months), local regeneration occurred in 11 UFs. The clinical and imaging characteristics of these patients were recorded and compared. Risk factors for local regeneration were determined through univariate and multivariate Cox regression analysis. Multivariate analysis revealed that the fertility desires, larger size of UFs (≥95.3 cm3), and hyperenhancement of UFs on contrast-enhanced ultrasound were independent risk factors for local regeneration after MWA. A predictive nomogram was constructed to predict the local regeneration after MWA of UFs. The concordance index (C-index) (C-index, 0.924; internal validation C-index, 0.895) and the 1- and 2-year area under the curve values (0.962, 0.927) all indicated that the nomogram had good predictive performance. Calibration and decision curve analysis curves further confirmed the model's accuracy and clinical utility. CONCLUSION: Fertility desires, larger size of UFs, and hyperenhancement on contrast-enhanced ultrasound were independent predictors of UFs local regeneration after MWA in our study. The nomogram constructed based on the abovementioned independent risk factors may help predict which UFs will develop local regeneration after MWA.

Ultrasound-MR fusion imaging combined with intraductal cooling via PTCD during microwave ablation of perihilar liver tumors: a retrospective pilot study.

PURPOSE: To explore the feasibility and safety of a microwave ablation (MWA) strategy involving intraductal chilled saline perfusion (ICSP) via percutaneous transhepatic cholangial drainage (PTCD) combined with ultrasound-magnetic resonance (US-MR) fusion imaging for liver tumors proximal to the hilar bile ducts (HBDs). METHODS: Patients with liver tumors proximal to the HBDs (≤5 mm) who underwent MWA at our hospital between June 2020 and April 2023 were retrospectively analyzed. The strategy of US-MR fusion imaging combined with PTCD-ICSP was used to assist the MWA procedures. The technical success, technique efficacy, local tumor progression, intrahepatic distant recurrence and complications were recorded and analyzed. RESULTS: In total, 12 patients with 12 liver tumors were retrospectively enrolled in this study. US-MR fusion imaging was utilized in all patients, and PTCD-ICSP assistance was successfully used for 4 nodules abutting HBDs (0 mm). The rates of technical success, technique efficacy, local tumor progression and intrahepatic distant recurrence were 91.7%, 83.3%, 0% and 8.3%, respectively. The major complication of biliary infection occurred in only one patient who had previously undergone left hemihepatectomy and bile-intestinal anastomosis. CONCLUSIONS: MWA for liver tumors proximal to HBDs assisted by US-MR fusion imaging combined with PTCD-ICSP was feasible and safe. This strategy made MWA of liver tumors abutting HBDs possible.

[Progress in immunotherapy for hepatocellular carcinoma].

Hepatocellular carcinoma (HCC) is one of the malignant tumors with the highest morbidity and mortality in the world. The morbidity and mortality of HCC are increasing every year. Liver cancer is a serious threat to public health in China and the death rate of patients with liver cancer in China is the highest in the world. Beyond surgery, chemotherapy and radiotherapy, immunotherapy is an emerging treatment for cancer, which could control and kill tumor cells by relieving the inhibitory status of immune cells in the tumor microenvironment and activating the immune function of the body. Immune checkpoint inhibitors, adoptive immunotherapy and tumor vaccine are the major treatments of immunotherapy. Compared with traditional therapy methods, immunotherapy could enhance immune function, delay tumor progression, prolong the survival time of patients, and becomes a hotspot in the basic and clinical cancer research. This article reviews the research progress of immunotherapy for liver cancer.