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射频消融联合经动脉化疗栓塞治疗肝细胞癌后的复发率及复发因素:一项回顾性队列研究

Recurrence rates and factors for recurrence after radiofrequency ablation combined with transarterial chemoembolization for hepatocellular carcinoma: a retrospective cohort study.

作者信息

Kim Jeong Han, Yim Hyung Joon, Lee Kwang Gyun, Kim Seung Young, Jung Eun Suk, Jung Young Kul, Kim Ji Hoon, Seo Yeon Seok, Yeon Jong Eun, Lee Hong Sik, Um Soon Ho, Byun Kwan Soo, Ryu Ho Sang

机构信息

Division of Gastroenterology and Hepatology, Department of Internal Medicine, Korea University Ansan Hospital, Korea University College of Medicine, Gojan-dong, Danwon-gu, Ansan-si, Gyeonggi-do, 425-707, Korea.

Division of Gastroenterology and Hepatology, Department of Internal Medicine, Korea University Anam Hospital, Korea University College of Medicine, Anam-dong, Seongbuk-gu, Seoul, 425-707, Korea.

出版信息

Hepatol Int. 2012 Apr;6(2):505-10. doi: 10.1007/s12072-011-9290-y. Epub 2011 Jul 5.

Abstract

PURPOSE

There have been reports that radiofrequency ablation (RFA) combined with transarterial chemoembolization (TACE) is as equally effective as surgical resection for the treatment of hepatocellular carcinoma (HCC). This study aimed to evaluate recurrence rate and risk factor of recurrence after RFA combined with TACE for early stage HCC.

METHODS

We reviewed the medical records of the patients who were diagnosed with early stage HCC between March 2006 and August 2008 at Korea University Medical Center and treated with RFA combined with TACE for curative intent (n = 65).

RESULTS

Recurrence rate was 40% (26 cases) and the time to recurrence was 14.9 months. Cumulative recurrence rate at 1 year was 20% (13 cases) and at 2 years was 33.8% (22 cases). Significant variables for recurrence were: (1) RFA repeated more than one session at initial therapy (P < 0.001) and (2) size of main lesion ≥2 cm (P = 0.047).

CONCLUSIONS

The recurrence rate of combination therapy was considerably high. Regardless of the therapy used, careful post-RFA follow-up is needed, especially if additional treatment is required after the first session or if the main lesion is ≥2 cm at the time of RFA.

摘要

目的

有报道称,射频消融(RFA)联合经动脉化疗栓塞术(TACE)治疗肝细胞癌(HCC)的效果与手术切除相当。本研究旨在评估RFA联合TACE治疗早期HCC后的复发率及复发危险因素。

方法

我们回顾了2006年3月至2008年8月在韩国大学医学中心被诊断为早期HCC并接受RFA联合TACE治疗以达到治愈目的的患者的病历(n = 65)。

结果

复发率为40%(26例),复发时间为14.9个月。1年时的累积复发率为20%(13例),2年时为33.8%(22例)。复发的显著变量为:(1)初始治疗时RFA重复超过一次(P < 0.001);(2)主要病灶大小≥2 cm(P = 0.047)。

结论

联合治疗的复发率相当高。无论采用何种治疗方法,RFA术后都需要仔细随访,尤其是在首次治疗后需要额外治疗或RFA时主要病灶≥2 cm的情况下。

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