Cabassa Paolo, Donato Francesco, Simeone Federica, Grazioli Luigi, Romanini Laura
Department of Radiology, University of Brescia, Piazzale Spedali Civili 1, Brescia 25100, Italy.
AJR Am J Roentgenol. 2006 May;186(5 Suppl):S316-21. doi: 10.2214/AJR.05.0243.
Our objective was to determine the efficacy of radiofrequency ablation, using expandable electrodes, in the treatment of patients with hepatocellular carcinoma (HCC).
In a 5-year period (1998-2003), 68 HCCs in 59 patients (age range, 47-88 years) were treated percutaneously with radiofrequency ablation using expandable needle electrodes. The mean lesion diameter was 3.1 cm (range, 1-12 cm). Fifty-one of 59 patients were in Child-Pugh class A, and eight were in class B. Follow-up was performed by helical CT at 1, 4, and 6 months and every 6 months after that. The mean follow-up was 24.1 months (range, 6-60 months). Survival and disease-free survival rates were evaluated separately by statistical analysis. Any complications were reported during follow-up.
Cumulative survival rates were 94.4%, 65%, and 43.1% at 1, 3, and 5 years, respectively. Median survival time was 23.6 months (range, 4-62 months). Maximum tumor diameter was associated with the probability of survival: 73% among patients with lesion diameters of 3 cm or less, 76.5% among patients with lesion diameters of 3-5 cm, and only 40% among patients with lesion diameters of more than 5 cm (p = 0.05, log-rank test; p = 0.07, Tarone-Ware test). In 34 (57.6%) of 59 patients during follow-up, new nodules noncontiguous with the treated nodule developed in the liver (tumor recurrences). Median disease-free survival rates were 32.1%, 28.1%, and 17.5% at 1, 2, and 3 years, respectively. One major complication occurred (hemoperitoneum that required transfusion).
Radiofrequency ablation with expandable electrodes is safe and effective in the treatment of HCC.
我们的目的是确定使用可扩张电极的射频消融术治疗肝细胞癌（HCC）患者的疗效。
在5年期间（1998 - 2003年），对59例患者（年龄范围47 - 88岁）的68个HCC进行了经皮射频消融治疗，使用可扩张针状电极。平均病灶直径为3.1 cm（范围1 - 12 cm）。59例患者中51例为Child-Pugh A级，8例为B级。术后1、4和6个月以及之后每6个月通过螺旋CT进行随访。平均随访时间为24.1个月（范围6 - 60个月）。通过统计分析分别评估生存率和无病生存率。随访期间报告任何并发症。
1年、3年和5年的累积生存率分别为94.4%、65%和43.1%。中位生存时间为23.6个月（范围4 - 62个月）。最大肿瘤直径与生存概率相关：病灶直径3 cm或以下的患者中为73%，病灶直径3 - 5 cm的患者中为76.5%，病灶直径超过5 cm的患者中仅为40%（p = 0.05，对数秩检验；p = 0.07，Tarone-Ware检验）。在59例患者的随访期间，有34例（57.6%）肝脏出现了与治疗结节不相邻的新结节（肿瘤复发）。1年、2年和3年的中位无病生存率分别为32.1%、28.1%和17.5%。发生了1例严重并发症（需要输血的腹腔内出血）。
使用可扩张电极的射频消融术治疗HCC安全有效。
