Jung Min Kyu, Lee Jong Hyup, Kim Tae Seok, Kim Hyun Soo, Cho Chang Min, Tak Won Young, Kweon Young Oh, Kim Sung Kook, Choi Yong Hwan, Chung Joon Mo
Department of Internal Medicine, Liver Research Institute, Kyungpook National University College of Medicine, Daegu, Korea.
Taehan Kan Hakhoe Chi. 2002 Jun;8(2):209-17.
BACKGROUND/AIMS: Radiofrequency ablation (RFA) is emerging as a new therapeutic method in the management of hepatocellular carcinoma (HCC). We report the results of 64 patients with a follow-up interval of 3 to 19 months.
Sixty-four patients with 82 nodules underwent ultrasound guided RFA. The mean tumor diameter was 2.5+/-1.0 cm. Laparoscopic ultrasound guided RFA was performed in 38 cases, and percutaneous ultrasound guided RFA in 26 cases. The therapeutic efficacy was evaluated by means of three-phase dynamic abdominal computed tomography (CT) performed within at least one week after ablating. The recurrence was evaluated after treatment by means of abdominal CT and alpha fetoprotein every 3 months. We calculated cumulative recurrence rates, survival rates of patients, and found out complication of RFA.
Cumulative recurrence rates in 3, 6, 12 months after RFA was 8.8%, 15.8%, 25.9%. 12 cases were recurred during follow-up. Among them, intrahepatic recurrences were noted in 11 cases, local recurrences in 3 cases. Cumulative survival curves indicated that survival rate was 95% at the third month, 94% at the sixth month, 81% at the twelfth month. After RFA, the alpha fetoprotein level was decreased significantly after 1 month (p<0.05), and serum transaminase levels were transiently elevated (p<0.01) but returned to normal within one week. Complications of RFA were not serious, and resolved spontaneously.
RFA can be considered a useful new treatment for HCC. Laparoscopic RFA is a useful procedure for the treatment of HCC regardless of its location.
背景/目的：射频消融（RFA）正成为肝细胞癌（HCC）治疗的一种新方法。我们报告了64例患者3至19个月的随访结果。
64例患者共82个结节接受了超声引导下的RFA。肿瘤平均直径为2.5±1.0厘米。38例行腹腔镜超声引导下RFA，26例行经皮超声引导下RFA。在消融后至少1周内通过腹部三期动态计算机断层扫描（CT）评估治疗效果。治疗后每3个月通过腹部CT和甲胎蛋白评估复发情况。我们计算了累积复发率、患者生存率，并找出RFA的并发症。
RFA后3、6、12个月的累积复发率分别为8.8%、15.8%、25.9%。随访期间12例复发。其中，肝内复发11例，局部复发3例。累积生存曲线显示，第三个月生存率为95%，第六个月为94%，第十二个月为81%。RFA后，1个月后甲胎蛋白水平显著下降（p<0.05），血清转氨酶水平短暂升高（p<0.01），但在1周内恢复正常。RFA的并发症不严重，可自行缓解。
RFA可被视为一种有效的HCC新治疗方法。腹腔镜RFA无论肿瘤位于何处，都是治疗HCC的一种有效方法。
