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肝细胞癌的射频消融:现状

Radiofrequency ablation of hepatocellular carcinoma: Current status.

作者信息

Minami Yasunori, Kudo Masatoshi

机构信息

Yasunori Minami, Masatoshi Kudo, Division of Gastroenterology and Hepatology, Department of Internal Medicine, Kinki University School of Medicine, 377-2 Ohno-Higashi Osaka-Sayama, 589-8511, Japan.

出版信息

World J Radiol. 2010 Nov 28;2(11):417-24. doi: 10.4329/wjr.v2.i11.417.

Abstract

Ablation therapy is one of the best curative treatment options for malignant liver tumors, and can be an alternative to resection. Radiofrequency ablation (RFA) of primary and secondary liver cancers can be performed safely using percutaneous, laparoscopic, or open surgical techniques, and RFA has markedly changed the treatment strategy for small hepatocellular carcinoma (HCC). Percutaneous RFA can achieve the same overall and disease-free survival as surgical resection for patients with small HCC. The use of a laparoscopic or open approach allows repeated placements of RFA electrodes at multiple sites to ablate larger tumors. RFA combined with transcatheter arterial chemoembolization will make the treatment of larger tumors a clinically viable treatment alternative. However, an accurate evaluation of treatment response is very important to secure successful RFA therapy. Since a sufficient safety margin (at least 0.5 cm) can prevent local tumor recurrences, an accurate evaluation of treatment response is very important to secure successful RFA therapy. To minimize complications of RFA, clinicians should be familiar with the imaging features of each type of complication. Appropriate management of complications is essential for successful RFA treatment.

摘要

消融治疗是恶性肝肿瘤最佳的根治性治疗选择之一,可作为手术切除的替代方案。原发性和继发性肝癌的射频消融(RFA)可通过经皮、腹腔镜或开放手术技术安全进行,并且RFA显著改变了小肝细胞癌(HCC)的治疗策略。对于小肝癌患者,经皮RFA可实现与手术切除相同的总生存率和无病生存率。采用腹腔镜或开放手术方法可在多个部位重复放置RFA电极以消融更大的肿瘤。RFA联合经动脉化疗栓塞将使更大肿瘤的治疗成为一种临床上可行的治疗选择。然而,准确评估治疗反应对于确保RFA治疗成功非常重要。由于足够的安全切缘(至少0.5 cm)可预防局部肿瘤复发,因此准确评估治疗反应对于确保RFA治疗成功非常重要。为了将RFA的并发症降至最低,临床医生应熟悉每种并发症的影像学特征。对并发症进行适当处理对于RFA治疗成功至关重要。

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