Teratani Takuma, Yoshida Haruhiko, Shiina Shuichiro, Obi Shuntaro, Sato Shinpei, Tateishi Ryosuke, Mine Norio, Kondo Yuji, Kawabe Takao, Omata Masao
Department of Gastroenterology, Faculty of Medicine, University of Tokyo, Japan.
Hepatology. 2006 May;43(5):1101-8. doi: 10.1002/hep.21164.
We evaluated the efficacy and safety of radiofrequency (RF) ablation for hepatocellular carcinoma (HCC) in presumably high-risk locations. Between February 1999 and December 2001, we performed RF ablation on 1419 nodules in 636 consecutive HCC patients, of which 231 nodules in 207 patients were in high-risk locations, defined as less than 5 mm from a large vessel or an extrahepatic organ. Eighty-one patients had a nodule adjacent to a large vessel, 145 patients had a nodule adjacent to an extrahepatic organ, of whom 19 also had one adjacent to a large vessel. Early complications and local tumor progression were analyzed with regard to the location of each nodule. The mean nodule diameter and average number per patient were 27 mm and 2.3, respectively. Early complications, within 30 days after ablation, occurred in 12 of 207 patients (5.8%) with a nodule in a high-risk location and in 15 of 429 patients (3.5%) without (P = .1776). There was no significant difference in local tumor progression rate between nodules in high-risk locations (1 year: 2.1%, 2 years: 3.1%, 3 years: 3.1%) and those elsewhere (1 year: 0.6%, 2 years: 1.7%, 3 years: 2.5%) (P = .2745). In conclusion, HCC nodules adjacent to a large vessel or extrahepatic organ were treated with RF ablation without compromising the efficacy of the procedure. However, even though without significant difference, some complications occurred at risky locations and need to be carefully considered.
我们评估了射频（RF）消融术治疗可能处于高风险位置的肝细胞癌（HCC）的疗效和安全性。1999年2月至2001年12月期间，我们对636例连续的HCC患者的1419个结节进行了射频消融，其中207例患者的231个结节位于高风险位置，定义为距离大血管或肝外器官小于5毫米。81例患者有一个结节邻近大血管，145例患者有一个结节邻近肝外器官，其中19例患者同时有一个结节邻近大血管。分析了每个结节位置的早期并发症和局部肿瘤进展情况。结节的平均直径和每位患者的平均结节数分别为27毫米和2.3个。在高风险位置有结节的207例患者中，12例（5.8%）在消融后30天内出现早期并发症，在无高风险位置结节的429例患者中，15例（3.5%）出现早期并发症（P = 0.1776）。高风险位置结节的局部肿瘤进展率（1年：2.1%，2年：3.1%，3年：3.1%）与其他位置结节的局部肿瘤进展率（1年：0.6%，2年：1.7%，3年：2.5%）之间无显著差异（P = 0.2745）。总之，邻近大血管或肝外器官的HCC结节采用射频消融治疗，并未影响该治疗方法的疗效。然而，尽管无显著差异，但在高风险位置仍发生了一些并发症，需要仔细考虑。
