Clinical Study Of Ultrasound-guided Percutaneous Radiofrequency Ablation Assisted By Water Isolation Technique In The Treatment Of Large Primary Liver Cancer Near Special Site

ObjectivePrimary hepatic carcinoma(PHC)near special sites(close to the diaphragm,stomach,colon,gallbladder,liver surface,etc.)is often considered to be a difficult problem in thermal ablation treatment.We used water isolation technology to completely inactivate the tumor under the premise of not damaging the surrounding organs and at the same time ensuring sufficient ablation range(the ablation range is more than 5mm above the tumor edge),aiming to explore the radiofrequency ablation(RF ablation).RFA).Safety and thoroughness of primary large hepatocellular carcinoma adjacent to specific sites.MethodsThe clinical data of 127 patients with primary large liver cancer who received ultrasound-guided RFA treatment in our hospital from October 2015 to January 2018 were retrospectively analyzed.A total of 132 lesions were confirmed by imaging as having edge distance less than 5mm from the special site.Among them,68 patients(70 adjacent lesions)who received water isolation assisted RFA were enrolled in the water isolation group,and 59 patients(62 adjacent lesions)who received conventional RFA were enrolled in the conventional treatment group.According to the size and location of liver tumors,different water isolation techniques and various combinations of techniques were selected for tumor ablation under the guidance of ultrasound in the water isolation treatment group.The whole process of ablation was monitored in real time,and the tumors were completely ablated under the premise of ensuring safety.All patients were closely followed up for 3 to 36 months.Imaging examination data(CEUS,enhanced MRI),tumor marker alpha fetoprotein(AFP),liver function indicator alanine aminotransferase(alanine aminotransferase)were collected.ALT),aspartate aminotransferase(AST),and total bilirubin(TBIL).The tumor complete ablation rate was recorded one month after treatment.Kaplan-Meier statistical method was used to analyze the progression-free survival(PFS)and overall survival(OS)of all patients after treatment,and the incidence of complications was recorded to evaluate its effectiveness and safety.Results1.The decreasing proportion of AFP level in the water isolation group at 1 month after treatment was better than that in the conventional treatment group,and the difference was statistically significant(P<0.05).There was no significant difference in liver function indexes between 2 groups 1 month after treatment and before treatment(P>0.05).2.The total ablation rate of the water isolation treatment group was 91.2%(62/68),which was higher than that of the conventional treatment group(78.0%,46/59),and the difference was statistically significant(P<0.05).3.The overall survival rates at 1,2 and 3 years after treatment in the water isolation group were 91.2%,86.8%and 72.1%,respectively,compared with 79.7%,71.2%and 54.2%in the conventional treatment group,with statistical significance(P<0.05).4.The progression-free survival rate of the water isolation treatment group was better than that of the conventional treatment group,and the difference was statistically significant(P<0.05).5.The incidence of postoperative complications in the water isolation treatment group was 39.7%(27/68),which was higher than that in the conventional treatment group(54.2%,32/59),and the difference was statistically significant(P<0.05).ConclusionsWater isolation technology assisted RFA in the treatment of primary large liver cancer can,to a certain extent,reduce tumor residual,improve the one-time complete ablation rate of tumor,improve the thorness of tumor ablation,improve the patients’tumor-free survival,extend the overall survival time,and reduce the incidence of complications after treatment.