Clinical efficacy and safety of percutaneous cryoablation combined with percutaneous ethanol injection in elderly patients with hepatocellular carcinoma aged 70 years or older / 临床肝胆病杂志

ABSTRACT

Objective To investigate the clinical efficacy and safety of percutaneous cryoablation combined with percutaneous ethanol injection (PEI) in elderly patients with early-stage hepatocellular carcinoma aged 70 years or older. Methods A retrospective analysis was performed for the clinical data of 92 elderly patients with hepatocellular carcinoma who were admitted to The Fifth Medical Center of Chinese PLA General Hospital from January 2014 to January 2018, among whom 46 underwent cryoablation alone (CRYO group) and 46 underwent cryoablation combined with PEI (combination therapy group). The two groups were compared in terms of clinical outcome, adverse reactions, and changes in liver function parameters after treatment, and the patients were followed up to observe tumor recurrence and survival. The t -test was used for comparison of normally distributed continuous data between two groups, and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups; the chi-square test was used for comparison of categorical data between two groups. The Kaplan-Meier method was used for survival analysis, and the log-rank test was used for comparison of survival curves. The Cox regression analysis was used to identify the independent risk factors for survival and prognosis. Results There was no significant difference in the response rate of initial ablation between the combination therapy group and the CRYO group (89.1% vs 73.9%, P > 0.05). There were no significant differences between the CRYO group and the combination therapy group in overall survival time and tumor-free survival rate after surgery ( P > 0.05), and compared with the CRYO group, the combination therapy group had significantly lower 1-, 2-, and 3-year local tumor progression rates (20%/21%/21% vs 30%/46%/46%, χ 2 =4.187, P 0.05), but 3 patients in the CRYO group experienced serious adverse reactions, while no patients in the combination therapy group experienced such reactions. Conclusion For elderly patients with early-stage hepatocellular carcinoma, cryoablation combined with PEI is safer and more effective than cryoablation alone and can significantly reduce local tumor progression rate.