手术切除与射频消融治疗小肝癌的疗效比较

何秀婷; 高普均; 徐宝达; 胡晓霞

doi:10.3969/j.issn.1001-5256.2013.08.008

手术切除与射频消融治疗小肝癌的疗效比较

DOI: 10.3969/j.issn.1001-5256.2013.08.008

吉林大学白求恩第一医院干部病房

详细信息

中图分类号: R735.7
计量
- 文章访问数: 3367
- HTML全文浏览量: 17
- PDF下载量: 651
- 被引次数: 0
出版历程
- 收稿日期: 2013-02-21
- 出版日期: 2013-08-20

Surgical resection versus radiofrequency ablation in treatment of small hepatocellular carcinoma

摘要

摘要:
目的比较小肝癌手术切除与射频消融（RFA）初治后疗效及复发情况。方法收集吉林大学白求恩第一医院2002年1月至2008年12月接受手术或RFA初治的97例小肝癌患者资料,并对治疗后满2年的患者进行随访,共随访到63例,手术和RFA治疗分别为34和29例,回顾性分析两种方法治疗小肝癌患者的预后复发情况。计量资料采用χ2检验,利用Cox回归分析比较影响患者复发相关的危险因素,并应用Log-rank进行两种无瘤生存率检验。结果手术与射频消融治疗小肝癌3个月、1、2 a复发率分别15%、38%、64%,21%、35%、45%,两者差异无统计学意义。初治后复发与治疗方法、性别、年龄、Child-Pugh分级、肿瘤大小、结节数目、是否合并有肝硬化、甲胎蛋白水平相关性差异无统计学意义,两者无瘤生存率差异无统计学意义。结论 RFA与肝癌切除术在治疗小肝癌取得相近的治疗效果,RFA有望成为替代手术治疗的一种理想的治疗方法。
- 肝肿瘤 /
- 肝切除术 /
- 射频消融
Abstract:
Objective To compare clinical efficacy and recurrence between surgical resection and radiofrequency ablation (RFA) in the treatment of small hepatocellular carcinoma (HCC) .Methods The clinical data of 97 patients with small HCC, who underwent surgical resection or RFA as the initial treatment in The First Hospital of Jilin University from January 2002 to December 2008, were collected.Sixty-three cases, who survived 2 years after treatment, were followed up;of the 63 cases, 34 underwent surgical resection, and 29 underwent RFA.The recurrence of these patients was analyzed retrospectively.The measurement data were analyzed by chi-square test.The Cox regression analysis was used for determining the risk factors for recurrence.The log-rank test was used for disease-free survival (DFS) difference analysis.Results The 3-month, 1-year, and 2-year intrahepatic recurrence rates for the patients who underwent surgical resection were 15%, 38%, and 64%, respectively, versus 21%, 35%, and 45% for those who underwent RFA, without significant differences between the two groups of patients.The intrahepatic recurrence after initial treatment was not significantly associated with treatment method, sex, age, Child-Pugh grade, tumor size, number of nodules, presence of cirrhosis, and alpha-fetoprotein level.There was no significant difference in DFS between the two groups of patients.Conclusion RFA produces a comparable outcome to that by surgical resection in the treatment of small HCC.RFA holds promise as a substitute for surgical resection.
- liver neoplasms /
- hepatectomy /
- radiofrequency ablation

HTML全文

参考文献(10)

[1]YE SL.Loco-regional therapy for liver cancer[J].J Clin Hepa-tol, 2013, 29 (1) :28-31. (in Chinese) 叶胜龙.肝癌的局部区域治疗[J].临床肝胆病杂志, 2013, 29 (1) :28-31.

[2]CHEN MS, LIU FR.The role of radiofrequency ablation in multidisci-plinary treatment of hepatocellular carcinoma[J].J Clin Hepatol, 2011, 27 (4) :368-371. (in Chinese) 陈敏山, 刘芙蓉.射频消融在肝癌多学科综合治疗中的应用[J].临床肝胆病杂志, 2011, 27 (4) :368-371.

[3]TAKETA K.Evaluation of tumor markers for the detection of hepa-tocellular carcinoma in Yangon General Hospital My-anmar[J].Acta Med Okayama, 2002, 56 (6) :317-320.

[4]CHO CM, TAK WY, KWEON YO, et al.The comparative resultsof radiofrequency ablation versus surgical resection for the treatmentof hepatocellular carcinoma[J].Korean J Hepatol, 2005, 11 (1) :59-71.

[5]OGIHARA M.Radiofrequency ablation versus surgical resection forsingle module hepatocellular carcinoma:long-term outcomes[J].HPB (Oxford) , 2005, 7 (3) :214-221.

[6]HONG SN, LEE SY, CHOI MS, et al.Comparing the outcomes of ra-diofrequency ablation and surgery in patients with a single small hepato-cellular carcinoma and well-preserved hepatic function[J].J ClinGastroenterol, 2005, 39 (3) :247-252.

[7]CHEN MS, LI JQ, ZHENG Y, et al.A prospective randomized tri-al comparing percutaneous local ablative therapy and partial hepa-tectomy for small hepatocellular carcinoma[J].Ann Surg, 2006, 243 (3) :321-328.

[8]LUPO L, PANZERA P, GIANNELLI G, et al.Single hepatocellularcarcinoma ranging from 3 to 5cm:radiofrequency ablation or resection[J].HPB (Oxford) , 2007, 9 (6) :429-434.

[9]MULLER S, NI Y, JAMART J, et al.Local recurrence after hepat-ic radiofrequency coagulation:multivariate meta-analysis and re-view of contributing factors[J].Ann Surg, 2005, 242 (2) :158-171.

[10]XIA JL, YE SL, ZOU HJ, et al.Prognosis and risk factors for re-currence of small liver cancer after a single session of percutaneousradiofrequency ablation[J].Chin J Cancer, 2004, 23 (9) :977-980. (in Chinese) 夏景林, 叶胜龙, 邹静怀, 等.单次经皮射频消融治疗小肝癌的预后及复发危险因素分析[J].癌症, 2004, 23 (9) :977-980.

施引文献

资源附件(0)

访问统计