Efficacy and safety of computed tomography-guided microwave ablation with fine needle-assisted puncture positioning technique for hepatocellular carcinoma.

BACKGROUND: In microwave ablation (MWA), although computed tomography (CT) scanning can overcome gas interference, it cannot achieve real-time localization. Therefore, the puncture technique is more important in CT-guided ablation. AIM: To compare the fine needle-assisted puncture (FNP) positioning technique and the conventional puncture (CP) technique for the safety and efficacy of CT-guided MWA in treating hepatocellular carcinoma (HCC). METHODS: This retrospective study included 124 patients with 166 tumor nodules from February 2018 and June 2021. Seventy patients received CT-guided MWA under the FNP technique (FNP group), and 54 patients received MWA under the CP technique (CP group). Intergroup comparisons were made regarding local tumor progression (LTP), recurrence-free survival (RFS), overall survival (OS), and complications. The influencing variables of LTP and RFS were analyzed through univariate and multivariate regressions. RESULTS: The 1-, 2-, and 3-year cumulative incidences of LTP in the FNP group were significantly lower than those in the CP group (7.4%, 12.7%, 21.3% vs 13.7%, 32.9%, 36.4%; P = 0.038). The 1-, 2-, and 3-year RFS rates in the FNP group were significantly higher than those in the CP group (80.6%, 73.3%, 64.0% vs 83.3%, 39.4%, and 32.5%, respectively; P = 0.008). The FNP technique independently predicted LTP and RFS. Minor complications in the FNP group were lower than those in the CP group (P < 0.001). The difference in median OS was insignificant between the FNP and CP groups (P = 0.229). CONCLUSION: The FNP technique used in CT-guided MWA may improve outcomes in terms of LTP, RFS, and procedure-related complications for HCC.

Efficacy of transcatheter arterial chemoembolization combined with cytokine-induced killer cell therapy on hepatocellular carcinoma: a comparative study.

BACKGROUND AND OBJECTIVE: Cytokine-induced killer (CIK) cells have high anti-tumor activity for hepatocellular carcinoma (HCC). Whether CIK cell therapy can eradicate residual cancer cells and prevent or postpone tumor relapse after transcatheter arterial chemoembolization (TACE) should be testified. This study was to evaluate the efficacy of CIK cell therapy combined with TACE on HCC. METHODS: A total of 146 consecutive patients with unresectable HCC were divided into combination group (72 patients treated with CIK cell therapy combined with TACE) and TACE group (74 patients treated only with TACE). The progression-free survival (PFS) and overall survival (OS) were analyzed. RESULTS: The 6-month, 1-year, and 2-year PFS rates were 72.2%, 40.4%, 25.3% in combination group, and 34.8%, 7.7%, 2.6% in TACE group. The median time to progression was 11 months [95% confidence interval (CI), 8-14 months] in combination group and 5 months (95% CI, 4-7 months) in TACE group. The estimated 6-month, 1-year, and 2-year OS rates were 90.3%, 71.9%, 62.4% in combination group, and 74.6%, 42.8%, 18.8% in TACE group. The median OS was 31 months (95% CI, 27-35 months) in combination group and 10 months (95% CI, 7-13 months) in TACE group. The times of TACE, ECOG performance status, and CIK cell therapy were independent prognostic factors for PFS and OS. CONCLUSION: Adjuvant immunotherapy with CIK cells could greatly improve the efficacy of TACE on HCC, and plays an important role in prolonging the PFS and OS of HCC patients after TACE.

[CT measurement and clinical application of double-row suture anchor reconstruction for the treatment of Tossy type III acromioclavicular joint dislocation].

OBJECTIVE: To study feasibility and reliability of reconstruction of the acromioclavicular ligament with double-row suture anchor for the treatment of acromioclavicular joint dislocation through coracoid coronal CT measurement, and to provide a new operation method for treating acromioclavicular joint dislocation. METHODS: Total 60 healthy people received CT examination of shoulder joint, including 30 males and 30 females, ranging in age from 18 to 50 years old. The coronal width, thickness and 20 degree camber angle in the medial part of the toot of coronal were measured using CT scan. The results were applied to clinical treatment for 12 patients with acromioclavicular joint dislocation of Tossy III type. RESULTS: The width in the medial part of the root of the coracoid was(17.65±1.82) mm(left side) and (17.67±1.80) mm(right side) in males; (16.55±1.78) mm(left side) and (16.52±1.74) mm (right side) in females. The vertical thickness of the roots of the coracoid: (13.11±2.11) mm(left side) and (13.16±2.09) mm(right side) in males;(12.79±2.21) mm(left side) and (12.76±2.19) mm (right side) in females. The thickness of 20 degrees camber angle of the coracoid roots: (16.32±1.74) mm (left side) and (16.30±1.69) mm(right side) in males; (15.68±1.44) mm(left side) and (15.67±1.43) mm(right side) in females. Total 12 patients were treated with anchor nail with extraversion 20 degrees. The postoperative X-ray films showed bone anchors were located in the coracoid process, no bone splitting. CONCLUSIONS: Double-row suture anchor of 5 mm diameter nails can be placed into coracoid with extraversion 20 degrees, which is safety.

Safety and efficacy of transcatheter arterial chemoembolization with embospheres in treatment of hepatocellular carcinoma.

OBJECTIVE: To investigate the safety and efficacy of transcatheter arterial chemoembolization (TACE) with embospheres for the treatment of unresectable hepatocellular carcinoma (HCC). METHODS: Patients with unresectable HCC who were treated with TACE followed by embosphere treatment (Embo-TACE) or conventional TACE (cTACE) between May 2010 and March 2014 were retrospectively included in this study. The Embo-TACE group received lipiodol and chemotherapeutic agent emulsion, followed by embospheres. The cTACE group received lipiodol and chemotherapeutic agent emulsion, followed by gelatin sponge pellets. Time to progression (TTP), overall survival (OS), overall response rate (ORR), and safety were compared between the two groups. Univariate and multivariate regression analyses of the factors affecting survival were conducted. RESULTS: The median TTP and OS in the Embo-TACE group were significantly longer than those in the cTACE group (TPP: 7.0 months vs 5.4 months, P = 0.035; OS: 15 months vs 12 months, P = 0.032). Seven days after the first TACE treatment, alanine aminotransferase level was higher in the cTACE group than in the Embo-TACE group (P = 0.015). The ORR did not significantly differ between the two groups (P = 0.827). Additional therapy and local responses one month after the first TACE treatment were associated with OS. CONCLUSIONS: Embo-TACE resulted in a significant improvement in TTP and OS for patients with unresectable HCC, compared with cTACE. Furthermore, Embo-TACE was better tolerated. Additional therapy and local responses one month after the first TACE were independent prognostic factors for OS.