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直径大于3厘米的肝细胞癌的射频消融疗效

Effectiveness of radiofrequency ablation for hepatocellular carcinomas larger than 3 cm in diameter.

作者信息

Poon Ronnie T P, Ng Kelvin K C, Lam Chi-Ming, Ai Victor, Yuen Jimmy, Fan Sheung-Tat

机构信息

Centre for the Study of Liver Disease and Department of Surgery, University of Hong Kong Medical Centre, Queen Mary Hospital, Pokfulam, Hong Kong, People's Republic of China.

出版信息

Arch Surg. 2004 Mar;139(3):281-7. doi: 10.1001/archsurg.139.3.281.

Abstract

HYPOTHESIS

Radiofrequency ablation is a safe and effective treatment for hepatocellular carcinomas 3.1 to 8.0 cm in diameter.

DESIGN

Case series with prospective data collection.

SETTING

Tertiary referral center.

PATIENTS

Eighty-six patients with hepatocellular carcinoma treated with radiofrequency ablation from May 1, 2001, to December 31, 2002, were placed into categories of those with tumors 3 cm or smaller (group 1, n = 51) and those with tumors 3.1 to 8.0 cm (group 2, n = 35) in diameter.

INTERVENTIONS

Radiofrequency ablation was performed with a single or cluster cool-tip electrode. The choice of treatment route was based on tumor size and position.

MAIN OUTCOME MEASURES

Complication, treatment mortality, and complete ablation rates.

RESULTS

Radiofrequency ablation was performed percutaneously in 26 patients in group 1 and 9 patients in group 2, with laparoscopy in 2 patients in group 1 and 1 patient in group 2, and with open operation in 23 patients in group 1 and 25 patients in group 2. The complication rates were 12% and 17% in group 1 and group 2, respectively (P =.48); treatment mortality rates were 0% and 3%, respectively (P =.41). Complete ablation rates after a single session of ablation assessed by means of computed tomography 1 month after treatment were 94% and 91% in group 1 and group 2, respectively (P =.68).

CONCLUSION

Radiofrequency ablation is a safe and effective treatment for patients with hepatocellular carcinomas 3.1 to 8.0 cm in diameter.

摘要

假设

射频消融术是治疗直径为3.1至8.0厘米肝细胞癌的一种安全有效的方法。

设计

前瞻性数据收集的病例系列研究。

地点

三级转诊中心。

患者

2001年5月1日至2002年12月31日接受射频消融术治疗的86例肝细胞癌患者,被分为肿瘤直径3厘米或更小的患者(第1组,n = 51)和肿瘤直径3.1至8.0厘米的患者(第2组,n = 35)。

干预措施

使用单根或集束冷循环电极进行射频消融。治疗途径的选择基于肿瘤大小和位置。

主要观察指标

并发症、治疗死亡率和完全消融率。

结果

第1组26例患者和第2组9例患者经皮进行射频消融,第1组2例患者和第2组1例患者通过腹腔镜进行,第1组23例患者和第2组25例患者通过开放手术进行。第1组和第2组的并发症发生率分别为12%和17%(P = 0.48);治疗死亡率分别为0%和3%(P = 0.41)。治疗后1个月通过计算机断层扫描评估,单次消融后的完全消融率在第1组和第2组分别为94%和91%(P = 0.68)。

结论

射频消融术是治疗直径为3.1至8.0厘米肝细胞癌患者的一种安全有效的方法。

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