Child-Pugh A级肝硬化的早期肝细胞癌非移植性潜在治愈性治疗的效果与肝移植相当。

Outcomes of nontransplant potentially curative therapy for early-stage hepatocellular carcinoma in Child-Pugh stage A cirrhosis is comparable with liver transplantation.

作者信息

Takahashi Shunsuke, Kudo Masatoshi, Chung Hobyung, Inoue Tatsuo, Nagashima Miki, Kitai Satoshi, Tatsumi Chie, Minami Yasunori, Ueshima Kazuomi, Fukunaga Toyokazu, Haji Seiji

机构信息

Division of Gastroenterology and Hepatology, Department of Internal Medicine, Kinki University School of Medicine, Ohno-Higashi, Osaka-Sayama, Japan.

出版信息

Dig Dis. 2007;25(4):303-9. doi: 10.1159/000106909.

DOI:10.1159/000106909

PMID:17960064

Abstract

BACKGROUND

This study was undertaken to assess the outcome of potentially curative therapy for early-stage hepatocellular carcinoma (HCC) in patients with Child-Pugh stage A cirrhosis as well as to investigate the impact of low-dose interferon (IFN) therapy after curative therapy on survival.

METHODS

This study retrospectively evaluated clinical outcomes in a cohort of 224 Child-Pugh stage A cirrhotic patients who received either resection (53 cases) or radiofrequency ablation (RFA: 171 cases) for HCC within Milan criteria. Thirty patients were treated with low-dose maintenance IFN therapy after initial curative therapy. The median follow-up period was 36.7 months.

RESULTS

The 5-year survival rate of all patients was 74.9%, with similar rates for the resection and RFA groups (70.4 vs. 76.8%; p = 0.561). The 5-year HCC recurrence rate was higher in the RFA group than the resection group (85.3 vs. 73.2%; p = 0.012). The maintenance IFN-treated group maintained their liver function within Child-Pugh stage A for a significantly longer time (median time 36.9 vs. 32.2 months; p = 0.0025).

CONCLUSION

The 5-year outcomes of resection and RFA in patients with Child-Pugh stage A cirrhosis and early stage HCC were comparable with liver transplantation. Low-dose, long-term maintenance IFN therapy after curative therapy was significantly beneficial on survival.

摘要

背景

本研究旨在评估Child-Pugh A级肝硬化患者早期肝细胞癌（HCC）潜在治愈性治疗的结果，并调查治愈性治疗后低剂量干扰素（IFN）治疗对生存的影响。

方法

本研究回顾性评估了224例符合米兰标准的Child-Pugh A级肝硬化患者，这些患者接受了肝癌切除术（53例）或射频消融术（RFA：171例）。30例患者在初始治愈性治疗后接受了低剂量维持IFN治疗。中位随访期为36.7个月。

结果

所有患者的5年生存率为74.9%，切除术组和RFA组的生存率相似（70.4%对76.8%；p = 0.561）。RFA组的5年肝癌复发率高于切除术组（85.3%对73.2%；p = 0.012）。维持IFN治疗组的肝功能在Child-Pugh A级内维持的时间明显更长（中位时间36.9个月对32.2个月；p = 0.0025）。