To investigate the feasibility, safety, and clinical outcomes of image-guided thermal ablation in patients with hepatic epithelioid hemangioendothelioma (HEHE). This was a multicenter retrospective investigation of 18 patients (43.9 years [SD ± 14.8]; 6 men) who underwent image-guided thermal ablation for HEHE between January 2013 and February 2023. A total of 31 ablation sessions (24 involving microwave ablation and 7 involving radiofrequency ablation) were evaluated. The rates of technical success, adverse events, and outcomes were assessed. The Kaplan‒Meier method was used to estimate progression-free survival (PFS) and overall survival (OS) rates. The risk factors affecting PFS were investigated using Cox proportional hazard regression analysis. The technical success rate was 93.5% (29/31). No major adverse events occurred after ablation. Local tumor progression occurred in 2 sessions (6.5%, 2/31) after ablation, and intrahepatic distant metastasis occurred in 16 sessions (51.6%, 16/31). During the medium follow-up time of 37.2 months (range, 3–117 months), the OS and PFS rates were 87.6% and 62.2%, respectively, at 1 year; 75.5% and 37.4%, respectively, at 3 years; and 75.5% and 37.4%, respectively, at 5 years. The median OS and PFS were 90.5 months (95% CI: 68.1–112.8) and 23.8 months (95% CI: 15.4–32.2), respectively. According to the multivariate analysis, a larger tumor size ( = .026) was associated with shorter PFS. Image-guided thermal ablation is a feasible and safe treatment option for patients with HEHE that results in good local tumor control and a favorable long-term prognosis.

中文翻译：

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图像引导热消融治疗肝上皮样血管内皮瘤：多中心经验

探讨图像引导热消融治疗肝上皮样血管内皮瘤（HEHE）患者的可行性、安全性和临床结果。这是一项多中心回顾性调查，对象为 18 名患者（43.9 岁 [SD ± 14.8]；6 名男性），他们在 2013 年 1 月至 2023 年 2 月期间接受了图像引导 HEHE 热消融术。总共 31 次消融治疗（24 次涉及微波消融，7 次涉及微波消融）。包括射频消融）进行了评估。评估了技术成功率、不良事件和结果。 Kaplan-Meier 方法用于估计无进展生存率 (PFS) 和总生存率 (OS)。使用 Cox 比例风险回归分析研究影响 PFS 的危险因素。技术成功率为93.5%（29/31）。消融后未发生重大不良事件。消融后2次出现局部肿瘤进展（6.5%，2/31），16次出现肝内远处转移（51.6%，16/31）。在 37.2 个月（范围 3-117 个月）的中期随访期间，1 年 OS 和 PFS 率分别为 87.6% 和 62.2%； 3 年时分别为 75.5% 和 37.4%； 5 年时分别为 75.5% 和 37.4%。中位 OS 和 PFS 分别为 90.5 个月（95% CI：68.1-112.8）和 23.8 个月（95% CI：15.4-32.2）。根据多变量分析，较大的肿瘤尺寸 (= .026) 与较短的 PFS 相关。图像引导热消融对于 HEHE 患者来说是一种可行且安全的治疗选择，可实现良好的局部肿瘤控制和良好的长期预后。