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肝肿瘤部分肝切除与局部消融联合治疗:荷兰的初步经验

Combining partial liver resection and local ablation of liver tumours: a preliminary Dutch experience.

作者信息

Fioole Bram, Jansen Maarten C, van Duijnhoven Frederieke H, van Hillegersberg Richard, van Gulik Thomas M, Borel Rinkes Inne Hm

机构信息

Department of Surgery, University Medical Centre Utrecht, Utrecht, The Netherlands.

出版信息

World J Surg Oncol. 2006 Jul 17;4:46. doi: 10.1186/1477-7819-4-46.

Abstract

BACKGROUND

The combination of partial liver resection and radiofrequency ablation (RFA) is a novel concept in the treatment of unresectable liver malignancies. The aim of this study is to evaluate the results of this combined strategy in the Netherlands.

METHODS

Thirty-five patients treated with a combination of partial liver resection and RFA were identified from a prospectively registered pooled multicentre database. All patients were operated between June 1999 and November 2003 in 8 medical centres in The Netherlands. Main outcome parameters were morbidity, mortality, local success rate, and survival.

RESULTS

Thirty-seven operations were performed in 35 patients. The group consisted of 20 male and 15 female patients with a median age of 59 years (range 41-76). Seventy-six lesions were resected and RFA was performed to ablate 82 unresectable liver tumours. Twelve patients developed a total of 24 complications, resulting in an overall perioperative morbidity rate of 32%. In two patients major complications resulted in postoperative death (postoperative mortality rate 5.4%). Local success rate after RFA was 88% and the estimated 1-, 2- and 3-year overall survival rates were 84%, 70% and 43%, respectively.

CONCLUSION

This strategy should only be performed following strict patient selection and within the context of prospective clinical trials.

摘要

背景

肝部分切除术与射频消融术(RFA)联合应用是治疗不可切除肝脏恶性肿瘤的一种新方法。本研究旨在评估荷兰采用这种联合治疗策略的效果。

方法

从一个前瞻性登记的多中心汇总数据库中识别出35例接受肝部分切除术与RFA联合治疗的患者。所有患者于1999年6月至2003年11月期间在荷兰的8个医疗中心接受手术。主要观察指标为发病率、死亡率、局部成功率和生存率。

结果

35例患者共进行了37次手术。该组包括20例男性和15例女性患者,中位年龄为59岁(范围41 - 76岁)。切除了76个病灶,并对82个不可切除的肝脏肿瘤进行了RFA治疗。12例患者共出现24种并发症,围手术期总发病率为32%。2例患者出现严重并发症导致术后死亡(术后死亡率5.4%)。RFA术后局部成功率为88%,估计1年、2年和3年总生存率分别为84%、70%和43%。

结论

这种治疗策略应仅在严格的患者选择后并在前瞻性临床试验的背景下进行。

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