Itamoto T, Katayama K, Fukuda S, Fukuda T, Yano M, Nakahara H, Okamoto Y, Sugino K, Marubayashi S, Asahara T
Department of Surgery II, Hiroshima University Faculty of Medicine, 1-2-3, Kasumi, Minami-Ku, Hiroshima, 734-8551, Japan.
Hepatogastroenterology. 2001 Sep-Oct;48(41):1401-5.
BACKGROUND/AIMS: To clarify the indication of percutaneous microwave coagulation therapy for hepatocellular carcinoma.
Thirty-three hepatocellular carcinoma patients who underwent percutaneous microwave coagulation therapy were enrolled in this study, including 18 primary and 15 recurrent hepatocellular carcinoma patients. We examined the local recurrence rates and the long-term results after the treatment.
The overall survival rates of the primary group at 1, 2, 3, 4 and 5 years were 94.4%, 77.8%, 77.8%, 77.8% and 48.6%, respectively, whereas those of the recurrent group were 100%, 85.7%, 66.7% and 50.0% at 1, 2, 3 and 4 years, respectively. Local recurrence after percutaneous microwave coagulation therapy was found in about 50% of patients in both groups. Seventeen of the 27 patients (63.0%) with a moderately or poorly differentiated hepatocellular carcinoma tumor had local recurrence, while none of the 6 patients with a well-differentiated hepatocellular carcinoma tumor did (P = 0.005).
Irrespective of primary or recurrent hepatocellular carcinoma, the indication of percutaneous microwave coagulation therapy as an alternative to hepatic resection should be limited to cases of a well-differentiated hepatocellular carcinoma tumor smaller than 2 cm in diameter.
背景/目的:明确经皮微波凝固治疗肝细胞癌的适应证。
本研究纳入33例行经皮微波凝固治疗的肝细胞癌患者,其中原发性肝细胞癌患者18例,复发性肝细胞癌患者15例。我们观察了治疗后的局部复发率和长期疗效。
原发性组1年、2年、3年、4年和5年的总生存率分别为94.4%、77.8%、77.8%、77.8%和48.6%,而复发性组1年、2年、3年和4年的总生存率分别为100%、85.7%、66.7%和50.0%。两组中约50%的患者在经皮微波凝固治疗后出现局部复发。27例中、低分化肝细胞癌患者中有17例(63.0%)出现局部复发,而6例高分化肝细胞癌患者均未出现局部复发(P = 0.005)。
无论原发性还是复发性肝细胞癌,经皮微波凝固治疗作为肝切除替代方案的适应证应限于直径小于2 cm的高分化肝细胞癌。