{"title":"放射学肿瘤负荷评分对微波消融后肝细胞癌米兰标准的预测价值：对长期预后和治疗计划的影响","authors":"Xiaolin Liu, Jing Wang, Feng Xu, Jing Chen, Mingyuan Zhu, Xiaoguang Wang","doi":"10.1002/cam4.70806","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Objective</h3>\n \n <p>This study aimed to investigate the predictive value of the radiographic tumor burden score (TBS) for long-term outcomes in hepatocellular carcinoma (HCC) patients meeting Milan criteria after microwave ablation (MWA) and to delineate its significance in guiding treatment planning.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>Retrospective analysis was conducted on clinical data from 198 HCC patients meeting Milan criteria, who underwent MWA at our hospital from January 2011 to December 2018. Using X-tile software, the optimal critical value of TBS was determined, leading to the categorization of patients into high- and low-TBS groups. Propensity score matching (PSM) was applied to balance covariates between these groups.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>Before PSM, the 5-year overall survival (OS) rate and recurrence-free survival (RFS) rate in the high-TBS (47 cases) and low-TBS groups (151 cases) were 32.8% versus 59.7% (<i>p</i> = 0.033) and 23.4% versus 50.9% (<i>p</i> = 0.016), respectively. Following PSM, the 5-year OS rate and RFS rate in the high-TBS (44 cases) and low-TBS groups (95 cases) were 30.2% versus 64.1% (<i>p</i> = 0.011) and 21.9% versus 45.9% (<i>p</i> = 0.0059), respectively. Cox analysis identified high TBS and percutaneous microwave ablation (PMWA) as independent risk factors for OS and RFS. The stratified analysis revealed that the median RFS time for patients undergoing laparoscopic microwave ablation (LMWA) (20 cases) and PMWA (24 cases) in the high-TBS group (44 cases) was 45 and 10.5 months, respectively (<i>p</i> = 0.006).</p>\n </section>\n \n <section>\n \n <h3> Conclusion</h3>\n \n <p>TBS emerged as a robust predictor for the long-term outcomes of HCC within Milan criteria after MWA. A higher TBS was associated with a diminished long-term survival rate. Notably, among HCC patients meeting Milan criteria, those with TBS > 3 exhibited a prolonged median RFS time following LMWA compared to PWMA.</p>\n </section>\n </div>","PeriodicalId":139,"journal":{"name":"Cancer Medicine","volume":"14 9","pages":""},"PeriodicalIF":3.5000,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cam4.70806","citationCount":"0","resultStr":"{\"title\":\"Predictive Value of Radiographic Tumor Burden Score in Hepatocellular Carcinoma Within Milan Criteria After Microwave Ablation: Implications for Long-Term Outcomes and Treatment Planning\",\"authors\":\"Xiaolin Liu, Jing Wang, Feng Xu, Jing Chen, Mingyuan Zhu, Xiaoguang Wang\",\"doi\":\"10.1002/cam4.70806\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Objective</h3>\\n \\n <p>This study aimed to investigate the predictive value of the radiographic tumor burden score (TBS) for long-term outcomes in hepatocellular carcinoma (HCC) patients meeting Milan criteria after microwave ablation (MWA) and to delineate its significance in guiding treatment planning.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Methods</h3>\\n \\n <p>Retrospective analysis was conducted on clinical data from 198 HCC patients meeting Milan criteria, who underwent MWA at our hospital from January 2011 to December 2018. Using X-tile software, the optimal critical value of TBS was determined, leading to the categorization of patients into high- and low-TBS groups. Propensity score matching (PSM) was applied to balance covariates between these groups.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>Before PSM, the 5-year overall survival (OS) rate and recurrence-free survival (RFS) rate in the high-TBS (47 cases) and low-TBS groups (151 cases) were 32.8% versus 59.7% (<i>p</i> = 0.033) and 23.4% versus 50.9% (<i>p</i> = 0.016), respectively. Following PSM, the 5-year OS rate and RFS rate in the high-TBS (44 cases) and low-TBS groups (95 cases) were 30.2% versus 64.1% (<i>p</i> = 0.011) and 21.9% versus 45.9% (<i>p</i> = 0.0059), respectively. Cox analysis identified high TBS and percutaneous microwave ablation (PMWA) as independent risk factors for OS and RFS. The stratified analysis revealed that the median RFS time for patients undergoing laparoscopic microwave ablation (LMWA) (20 cases) and PMWA (24 cases) in the high-TBS group (44 cases) was 45 and 10.5 months, respectively (<i>p</i> = 0.006).</p>\\n </section>\\n \\n <section>\\n \\n <h3> Conclusion</h3>\\n \\n <p>TBS emerged as a robust predictor for the long-term outcomes of HCC within Milan criteria after MWA. A higher TBS was associated with a diminished long-term survival rate. Notably, among HCC patients meeting Milan criteria, those with TBS > 3 exhibited a prolonged median RFS time following LMWA compared to PWMA.</p>\\n </section>\\n </div>\",\"PeriodicalId\":139,\"journal\":{\"name\":\"Cancer Medicine\",\"volume\":\"14 9\",\"pages\":\"\"},\"PeriodicalIF\":3.5000,\"publicationDate\":\"2025-04-24\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cam4.70806\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Cancer Medicine\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://onlinelibrary.wiley.com/doi/10.1002/cam4.70806\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"ONCOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Cancer Medicine","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1002/cam4.70806","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"ONCOLOGY","Score":null,"Total":0}
Predictive Value of Radiographic Tumor Burden Score in Hepatocellular Carcinoma Within Milan Criteria After Microwave Ablation: Implications for Long-Term Outcomes and Treatment Planning
Objective
This study aimed to investigate the predictive value of the radiographic tumor burden score (TBS) for long-term outcomes in hepatocellular carcinoma (HCC) patients meeting Milan criteria after microwave ablation (MWA) and to delineate its significance in guiding treatment planning.
Methods
Retrospective analysis was conducted on clinical data from 198 HCC patients meeting Milan criteria, who underwent MWA at our hospital from January 2011 to December 2018. Using X-tile software, the optimal critical value of TBS was determined, leading to the categorization of patients into high- and low-TBS groups. Propensity score matching (PSM) was applied to balance covariates between these groups.
Results
Before PSM, the 5-year overall survival (OS) rate and recurrence-free survival (RFS) rate in the high-TBS (47 cases) and low-TBS groups (151 cases) were 32.8% versus 59.7% (p = 0.033) and 23.4% versus 50.9% (p = 0.016), respectively. Following PSM, the 5-year OS rate and RFS rate in the high-TBS (44 cases) and low-TBS groups (95 cases) were 30.2% versus 64.1% (p = 0.011) and 21.9% versus 45.9% (p = 0.0059), respectively. Cox analysis identified high TBS and percutaneous microwave ablation (PMWA) as independent risk factors for OS and RFS. The stratified analysis revealed that the median RFS time for patients undergoing laparoscopic microwave ablation (LMWA) (20 cases) and PMWA (24 cases) in the high-TBS group (44 cases) was 45 and 10.5 months, respectively (p = 0.006).
Conclusion
TBS emerged as a robust predictor for the long-term outcomes of HCC within Milan criteria after MWA. A higher TBS was associated with a diminished long-term survival rate. Notably, among HCC patients meeting Milan criteria, those with TBS > 3 exhibited a prolonged median RFS time following LMWA compared to PWMA.
期刊介绍：
Cancer Medicine is a peer-reviewed, open access, interdisciplinary journal providing rapid publication of research from global biomedical researchers across the cancer sciences. The journal will consider submissions from all oncologic specialties, including, but not limited to, the following areas:
Clinical Cancer Research
Translational research ∙ clinical trials ∙ chemotherapy ∙ radiation therapy ∙ surgical therapy ∙ clinical observations ∙ clinical guidelines ∙ genetic consultation ∙ ethical considerations
Cancer Biology:
Molecular biology ∙ cellular biology ∙ molecular genetics ∙ genomics ∙ immunology ∙ epigenetics ∙ metabolic studies ∙ proteomics ∙ cytopathology ∙ carcinogenesis ∙ drug discovery and delivery.
Cancer Prevention:
Behavioral science ∙ psychosocial studies ∙ screening ∙ nutrition ∙ epidemiology and prevention ∙ community outreach.
Bioinformatics:
Gene expressions profiles ∙ gene regulation networks ∙ genome bioinformatics ∙ pathwayanalysis ∙ prognostic biomarkers.
Cancer Medicine publishes original research articles, systematic reviews, meta-analyses, and research methods papers, along with invited editorials and commentaries. Original research papers must report well-conducted research with conclusions supported by the data presented in the paper.
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