Application of the three-dimensional visualization ablation planning system in radiofrequency ablation for hepatocellular carcinoma / 临床肝胆病杂志

ABSTRACT

Objective To investigate the significance of the three-dimensional visualization ablation planning system in radiofrequency ablation for liver cancer. Methods A total of 71 patients who received radiofrequency ablation for hepatocellular carcinoma in Beijing Ditan Hospital, Capital Medical University from July 2017 to December 2020 were enrolled as subjects. The 34 patients in the three-dimensional group used the three-dimensional visualization ablation planning system for radiofrequency protocol planning before surgery and the 37 patients in the two-dimensional group used the two-dimensional image for radiofrequency protocol planning before surgery. The two groups were compared in terms of the indices such as the first-attempt success rate of puncture, complete tumor ablation rate, and tumor-free survival. The Fisher's exact test, the chi-square test of continuous correction, or the Pearson chi-square test was used for comparison of categorical data between two groups; the t -test was used for comparison of normally distributed continuous data between groups, and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between groups. The Kaplan-Meier method was used to plot survival curves, and the Log-rank (Mantel-Cox) test was used for comparison of tumor recurrence and survival; the Cox proportional-hazards regression model analysis was used to investigate the influencing factors for tumor-free survival. Results Compared with the two-dimensional group, the three-dimensional group had a significantly higher first-attempt success rate of puncture (94.12% vs 75.68%, Pearson χ 2 =4.183, P =0.041) and a significantly shorter median time of puncture (5 minutes vs 7 minutes, Z =-2.407, P =0.013). There was no significant difference in complete ablation rate between the three-dimensional group and the two-dimensional group (97.06% vs 91.89%, continuous correction χ 2 =0.183, P =0.669). There were significant differences in the 1-, 2-, and 4-year cumulative tumor-free survival rates between the three-dimensional group and the two-dimensional group (90.8%/78.8%/72.8% vs 61.5%/55.9%/44.7%, χ 2 =5.073, P =0.024). The multivariate Cox regression analysis showed that preoperative planning method, complete or incomplete ablation, and alpha-fetoprotein at 1 month after surgery were independent influencing factors for the tumor-free survival of patients with liver cancer after radiofrequency ablation (all P < 0.05). Conclusion Radiofrequency ablation planning via the three-dimensional visualization ablation planning system can ensure the therapeutic effect of radiofrequency ablation, reduce the recurrence rate of liver cancer, and prolong the tumor-free survival of patients.