MR-guided microwave ablation of hepatocellular carcinoma (HCC): is general anesthesia more effective than local anesthesia?
| Autor: | Jing Li, Dechao Jiao, Xinwei Han, Chaoyan Wang, Zaoqu Liu, Zhaonan Li |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Male
Cancer Research Hepatocellular carcinoma Kaplan-Meier Estimate Pain Procedural Magnetic Resonance Imaging Interventional 030218 nuclear medicine & medical imaging Microwave ablation 0302 clinical medicine Local anesthesia Microwaves RC254-282 medicine.diagnostic_test Liver Neoplasms Neoplasms. Tumors. Oncology. Including cancer and carcinogens Interventional radiology Middle Aged Prognosis Progression-Free Survival Tumor Burden Oncology Liver 030220 oncology & carcinogenesis Anesthesia Disease Progression Female medicine.symptom Research Article Adult Carcinoma Hepatocellular Sedation Anesthesia General 03 medical and health sciences Magnetic resonance imaging Genetics medicine Humans Aged Retrospective Studies Radiofrequency Ablation Proportional hazards model business.industry medicine.disease Tumor progression business Anesthesia Local |
| Zdroj: | BMC Cancer, Vol 21, Iss 1, Pp 1-9 (2021) BMC Cancer |
| ISSN: | 1471-2407 |
| Popis: | Background Percutaneous magnetic resonance-guided (MR-guided) MWA procedures have traditionally been performed under local anesthesia (LA) and sedation. However, pain control is often difficult to manage, especially in some cases when the tumor is large or in a specific location, such as near the abdominal wall or close to the hepatic dome. This study retrospectively compared the results of general anesthesia (GA) and local anesthesia (LA) for MR-guided microwave ablation (MWA) in patients with hepatocellular carcinoma (HCC ≤ 5.0 cm) to investigate whether different anesthesia methods lead to different clinical outcomes. Methods The results of the analysis include procedure-related complications, imaging response, and the time to complete two sets of procedures. According to the type of anesthesia, the Kaplan-Meier method was used to compare the local tumor progression (LTP) of the two groups who underwent MR-guided MWA. Results All patients achieved technical success. The mean ablation duration of each patient in the GA group and LA group was remarkably different (P = 0.012). Both groups had no difference in complications or LTP (both P > 0.05). Notably, the tumor location (challenging locations) and the number of lesions (2–3 lesions) could be the main factors affecting LTP (p = 0.000, p = 0.015). Univariate Cox proportional hazard regression indicated that using different anesthesia methods (GA and LA) was not associated with longer LTP (P = 0.237), while tumor location (challenging locations) and the number of lesions (2–3 lesions) were both related to shorter LTP (P = 0.000, P = 0.020, respectively). Additionally, multivariate Cox regression further revealed that the tumor location (regular locations) and the number of lesions (single) could independently predict better LTP (P = 0.000, P = 0.005, respectively). Conclusions No correlation was observed between GA and LA for LTP after MR-guided MWA. However, tumors in challenging locations and the number of lesions (2–3 lesions) appear to be the main factors affecting LTP. |
| Databáze: | OpenAIRE |
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