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超声引导下经皮肝癌冷冻治疗。

Ultrasound-guided percutaneous cryotherapy of hepatocellular carcinoma.

机构信息

Department of Hepatobiliary Surgery, The First People's Hospital of Foshan, Foshan, 528000 Guang Dong, People's Republic of China.

出版信息

Int J Surg. 2011;9(2):188-91. doi: 10.1016/j.ijsu.2010.11.008. Epub 2010 Nov 18.

Abstract

BACKGROUND

Reports on percutaneous cryoablation to treat patients with HCC are sparse in the medical literature. This study aimed to determine the safety and efficacy of percutaneous cryotherapy for unresectable or recurrent hepatocellular carcinoma (HCC).

METHODS

The results of 40 patients with unresectable HCC and 26 patients with recurrent HCC treated with ultrasound-guided percutaneous cryotherapy from January 2006 to June 2009 were retrospectively analyzed.

RESULTS

We used percutaneous cryotherapy to treat 76 tumors in 40 patients with unresectable and 76 tumors in 26 patients with recurrent HCC. The size of the tumors was 2.8 ± 1.7 cm (mean ± S.D.). The mean number of treatment sessions for unresectable and recurrent HCC were 1.7 and 1.4, respectively. All cryotherapy procedures were technically successful. No procedure-related death was observed. The overall complication rate was 12.1%. Patients with unresectable HCC had 1-, and 3-year overall survival rates of 81.4%, and 60.3%, while the disease-free survival rates at 1 year and 3 years were 67.6% and 20.8%, respectively. Patients with recurrent HCC had 1-, and 3-year overall survival rates of 70.2%, and 28.8%, while the disease-free survival rates at 1 year and 3 years were 53.8% and 7.7%, respectively.

CONCLUSION

Ultrasound-guided percutaneous cryotherapy was safe and efficacious in the treatment of unresectable and recurrent HCC. Further randomized trials are needed to compare the safety and efficacy of cryotherapy with other forms of percutaneous treatment so that an unbiased therapeutic strategy can be devised.

摘要

背景

医学文献中关于经皮冷冻消融治疗肝细胞癌(HCC)的报道较少。本研究旨在评估超声引导经皮冷冻消融治疗不可切除或复发性 HCC 的安全性和有效性。

方法

回顾性分析 2006 年 1 月至 2009 年 6 月期间,40 例不可切除 HCC 患者和 26 例复发性 HCC 患者接受超声引导经皮冷冻消融治疗的结果。

结果

我们使用经皮冷冻消融治疗 40 例不可切除 HCC 和 26 例复发性 HCC 的 76 个肿瘤。肿瘤大小为 2.8±1.7cm(均值±标准差)。不可切除和复发性 HCC 的平均治疗次数分别为 1.7 和 1.4 次。所有冷冻消融手术均技术成功,无与手术相关的死亡。总并发症发生率为 12.1%。不可切除 HCC 患者的 1 年和 3 年总生存率分别为 81.4%和 60.3%,1 年和 3 年无病生存率分别为 67.6%和 20.8%。复发性 HCC 患者的 1 年和 3 年总生存率分别为 70.2%和 28.8%,1 年和 3 年无病生存率分别为 53.8%和 7.7%。

结论

超声引导经皮冷冻消融治疗不可切除和复发性 HCC 是安全有效的。需要进一步进行随机试验,比较冷冻消融与其他经皮治疗方法的安全性和疗效,以便制定出公正的治疗策略。

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