Effectiveness and safety of ultrasound-guided ablation in treatment of primary liver cancer in dangerous areas

Abstract

Objective To investigate the effectiveness and safety of ultrasound-guided percutaneous local ablation in the treatment of liver cancer in dangerous areas. Methods A total of 179 patients with primary liver cancer who were admitted to Tianjin Second People's Hospital from January 2014 to September 2017 and underwent ultrasound-guided ablation for the first time were enrolled, and according to tumor location, the patients were divided into dangerous area group with 134 patients and non-dangerous area group with 45 patients. All patients received ablation therapy. The patients were followed up to observe tumor recurrence and death, and the patients without recurrence or death were followed up to September 2019. The two groups were compared in terms of complications after ablation, complete tumor response rate, tumor recurrence or progression, and postoperative survival. The two-independent-samples t-test was used for comparison of normally distributed continuous data between two groups; The Mann-Whitney U test was used for comparison of non- normally distributed continuous data between two groups, and the chi-square test was used for comparison of categorical data between two groups; the Kaplan-Meier method was used to analyze local tumor progression rate and cumulative survival rate, and the log-rank test was used for comparison between two groups. Results There were no significant differences in baseline levels between the two groups. There were no significant differences between the dangerous area group and the non-dangerous area group in the incidence rates of mild complications (42.5% vs 51.1%, χ2=1.002, P=0.317) and severe complications (6.0% vs 2.22%, χ2=0.453, P=0.290) and the reduction rate and normalization rate of alpha-fetoprotein within 1 month after ablation (reduction rate: 75.0% vs 80.0%, χ2=0.464, P=0.496; normalization rate: 33.9% vs 26.3%, χ2=0.381, P=0.537), and there was also no significant difference in complete tumor response rate between the two groups (91.8% vs 93.3%, P=0.990). The dangerous area group had 1- and 2-year progression-free survival rates of 60.7% and 37.1%, respectively, and the non-dangerous area group had 1- and 2-year progression-free survival rates of 63.5% and 55.0%, respectively, with a median progression-free survival time of 18 months and 27 months, respectively, and there was no significant difference between the two groups (χ2=0.573, P=0.449). The dangerous area group had 1- and 2-year cumulative survival rates of 96.8% and 90.3%, respectively, and the non-dangerous area group had 1- and 2-year cumulative survival rates of 93.3% and 87.8%, respectively, with no significant difference between the two groups (χ2=0.110, P=0.731). Conclusion Ultrasound-guided percutaneous local ablation is a feasible, safe, and effective method for the treatment of liver cancer in dangerous areas.