经皮射频消融联合其他微创治疗用于肝切除术后复发性肝细胞癌
[Percutaneous radiofrequency ablation combined with other minimally invasive treatments for recurrent hepatocellular carcinoma after hepatectomy].
作者信息
Xu Li, Li Peng, Chen Min-shan, Pang Xiong-hao, Gao Heng-jun, Peng Zhen-wei, Liang Hui-hong, Zhang Yao-jun, Li Jin-qing
机构信息
Department of Hepatobiliary Surgery, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in Southern China, Guangzhou 510060, China.
出版信息
Zhonghua Wai Ke Za Zhi. 2008 Nov 1;46(21):1617-20.
OBJECTIVE
To evaluate the efficacy and safety of percutaneous radiofrequency ablation (PRFA) and combined with other minimally invasive treatments for recurrent hepatocellular carcinoma (RHCC) after hepatectomy.
METHODS
Eighty-four patients with RHCC after hepatectomy who were treated with PRFA or combined with other minimally invasive therapies between August 1999 and February 2008 were analyzed retrospectively.
RESULTS
There was no treatment related mortality in the study population, and the morbidity was 2.4% (2/84). The complete ablation rate was 94.0% (79/84), and the 1-, 3- and 5-year overall survival rates were 74.9%, 54.9% and 48.2%, respectively. The 1-, 3- and 5-year overall survival rates of patients with recurrent interval after hepatectomy less than 1 year and over 1 year were 72.1%, 36.2%, 24.2% and 76.8%, 70.6% and 65.1%, respectively (P = 0.040). The 1-, 3- and 5-year overall survival rates of patients with tumor size <or= 3 cm and > 3 cm were 83.2%, 67.7%, 67.7% and 59.1%, 24.2%, 12.1%, respectively (P = 0.003). The 1-, 3- and 5-year overall survival rates of patients treated with PRFA alone and combined with percutaneous ethanol injection (PEI) were 66.7%, 33.3%, 22.2% and 76.5%, 57.3%, 57.3%, respectively (P = 0.017). The 1-, 3- and 5-year overall survival rates of patients treated with PRFA alone and combined with transcatheter hepatic arterial chemoembolization (TACE) were 55.6%, 24.7%, 24.7% and 81.6%, 66.0%, 57.5%, respectively (P = 0.001).
CONCLUSIONS
PRFA is an effective and safe treatment for RHCC, and tumor size and recurrent interval after hepatectomy are important prognostic factors. Combination with PEI or TACE may improve the efficacy of PRFA for treatment of RHCC.
目的
评估经皮射频消融（PRFA）及联合其他微创治疗方法对肝切除术后复发性肝细胞癌（RHCC）的疗效和安全性。
方法
回顾性分析1999年8月至2008年2月间接受PRFA或联合其他微创治疗的84例肝切除术后RHCC患者。
结果
研究人群中无治疗相关死亡病例，并发症发生率为2.4%（2/84）。完全消融率为94.0%（79/84），1年、3年和5年总生存率分别为74.9%、54.9%和48.2%。肝切除术后复发间隔小于1年和大于1年患者的1年、3年和5年总生存率分别为72.1%、36.2%、24.2%和76.8%、70.6%和65.1%（P = 0.040）。肿瘤大小≤3 cm和＞3 cm患者的1年、3年和5年总生存率分别为83.2%、67.7%、67.7%和59.1%、24.2%、12.1%（P = 0.003）。单纯PRFA治疗和联合经皮乙醇注射（PEI）治疗患者的1年、3年和5年总生存率分别为66.7%、33.3%、22.2%和76.5%、57.3%、57.3%（P = 0.017）。单纯PRFA治疗和联合经导管肝动脉化疗栓塞术（TACE）治疗患者的1年、3年和5年总生存率分别为55.6%、24.7%、24.7%和81.6%、66.0%、57.5%（P = 0.001）。
结论
PRFA是治疗RHCC的一种有效且安全的方法，肿瘤大小和肝切除术后复发间隔是重要的预后因素。联合PEI或TACE可能提高PRFA治疗RHCC的疗效。
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