Improvement of the primary efficacy of microwave ablation of malignant liver tumors by using a robotic navigation system
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28 may 2020
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Categoría del artículo: Research Article
Publicado en línea: 28 may 2020
Páginas: 295 - 300
Recibido: 17 feb 2020
Aceptado: 03 may 2020
DOI: https://doi.org/10.2478/raon-2020-0033
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© 2020 Jan Schaible, Benedikt Pregler, Niklas Verloh, Ingo Einspieler, Wolf Bäumler, Florian Zeman, Andreas Schreyer, Christian Stroszczynski, Lukas Beyer, published by Sciendo
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.
Influence of tumor characteristics on primary efficacy
| Predictor | Estimate | Std.err | Wald | p-value | |
|---|---|---|---|---|---|
| Long axis, mm | ≤ 30 | Reference | 0.3657 | 5.68 | |
| Guidance | Freehand | Reference | 0.3256 | 6.13 | |
| HCC | Reference | ||||
| Tumor entity | CRC | 0.2922 | 0.4483 | 0.42 | 0.5145 |
| Other | 0.0832 | 0.5228 | 0.03 | 0.8736 | |
| I | Reference | ||||
| II | − 0.3956 | 1.0798 | 0.13 | 0.7141 | |
| III | − 0.0449 | 1.1025 | 0.00 | 0.9675 | |
| IVa | 0.2688 | 1.1180 | 0.06 | 0.8100 | |
| Liver segment | IVb | − 0.2539 | 1.1597 | 0.05 | 0.8267 |
| V | 0.5961 | 1.1285 | 0.28 | 0.5974 | |
| VI | 0.9036 | 1.1736 | 0.59 | 0.4413 | |
| VII | 0.0656 | 1.1090 | 0.00 | 0.9528 | |
| VIII | − 0.1069 | 1.0929 | 0.01 | 0.9221 |
Monte Carlo simulation of primary technique efficacy rate depending on tumor size and antenna guidance
| Long axis, mm | Guidance | CI-2.5% | Median | CI-97.5% |
|---|---|---|---|---|
| ≤ 30 | Freehand | 0.60 | 0.75 | 0.86 |
| > 30 | Freehand | 0.34 | 0.55 | 0.76 |
| ≤ 30 | Robotic | 0.78 | 0.87 | 0.92 |
| > 30 | Robotic | 0.55 | 0.74 | 0.87 |
Tumors treated using freehand and robotic guidance
| Ablation technique | Long axis, mm | Liver segment, n (%) | Device, n (%) | Primary efficacy, n (%) | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Min | Mean (SD) | Max | I | II | III | IVa | IVb | V | VI | VII | VIII | Acculis | Emprint | Complete | Incomplete | |
| Freehand (n = 119) | 4 | 19.79 | 85 | 1 | 10 | 16 | 16 | 9 | 13 | 17 | 15 | 22 | 65 | 54 | 9 | 28 |
| Robotic guidance (n = 249) | 3 | 18.78 | 64 | 6 | 24 | 20 | 26 | 16 | 38 | 36 | 36 | 47 | 143 | 106 | 219 | 30 |
Patient characteristics
| Age, years | Sex, n, (%) | Treated tumors per patient, n | Tumor entity, n (%) | |||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Min. | Mean (SD) | Median (IQR) | Max. | Male | Female | Median (IQR) | Max. | HCC | CRC | CCC | Other | |
| Patients (n = 192) | 15 | 65.03 | 64.00 | 83 | 156 | 36 | 1.00 | 9 | 139 (72) | 29 | 7 | 17 |