手术切除与射频消融治疗巴塞罗那临床肝癌分期非常早期/早期肝癌患者的生存比较。
Survival comparison between surgical resection and radiofrequency ablation for patients in BCLC very early/early stage hepatocellular carcinoma.
机构信息
Division of Hepato-Gastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan.
出版信息
J Hepatol. 2012 Feb;56(2):412-8. doi: 10.1016/j.jhep.2011.05.020. Epub 2011 Jul 12.
BACKGROUND & AIMS: To compare the survival between surgical resection (SR) and radiofrequency ablation (RFA) in patients with hepatocellular carcinoma (HCC) in Barcelona Clinic Liver Cancer (BCLC) very early/early stage.
METHODS
Between 2002 and 2009, patients with newly diagnosed BCLC very early/early stage HCC who received SR or RFA were enrolled. Medical records were reviewed. The cumulative overall survival (OS) and disease-free survival (DFS) were compared.
RESULTS
A total of 605 patients, including 143 very early (SR: 52; RFA: 91) and 462 early stages (SR: 208; RFA: 254) were enrolled. For very early stage, the 3- and 5-year OS rates were 98% and 91.5% for SR, and 80.3% and 72% for RFA, respectively (p=0.073). The 3- and 5-year DFS rates were 62.1% and 40.7% for SR, and 39.8% and 29.3% for RFA, respectively (p=0.006). Either multiple adjustment by Cox model or match analysis based on propensity score showed no significant difference in OS between the two groups. For early stage, the 3- and 5-year OS rates were 87.8% and 77.2% for SR, and 73.5% and 57.4% for RFA, respectively (p=0.001). The 3- and 5-year DFS rates were 59.9% and 50.8% for SR, and 28.3% and 14.1% for RFA, respectively (p<0.001). After adjusting covariates, there was no significant difference in OS between the two groups. However, SR was superior to RFA in DFS.
CONCLUSIONS
For HCC patients in BCLC very early/early stage, there was no significant difference in OS between SR and RFA. However, SR yielded better DFS than RFA.
背景与目的
比较巴塞罗那临床肝癌分期（BCLC）极早期/早期肝细胞癌（HCC）患者行手术切除（SR）与射频消融（RFA）的生存情况。
方法
纳入 2002 年至 2009 年间接受 SR 或 RFA 治疗的新诊断为 BCLC 极早期/早期 HCC 患者。回顾病历记录。比较累积总生存（OS）和无疾病生存（DFS）。
结果
共纳入 605 例患者，其中极早期 143 例（SR：52 例；RFA：91 例），早期 462 例（SR：208 例；RFA：254 例）。极早期患者中，SR 的 3 年和 5 年 OS 率分别为 98%和 91.5%，RFA 分别为 80.3%和 72%（p=0.073）。SR 的 3 年和 5 年 DFS 率分别为 62.1%和 40.7%，RFA 分别为 39.8%和 29.3%（p=0.006）。多因素 Cox 模型调整或倾向评分匹配分析均显示两组 OS 无显著差异。对于早期患者，SR 的 3 年和 5 年 OS 率分别为 87.8%和 77.2%，RFA 分别为 73.5%和 57.4%（p=0.001）。SR 的 3 年和 5 年 DFS 率分别为 59.9%和 50.8%，RFA 分别为 28.3%和 14.1%（p<0.001）。调整协变量后，两组 OS 无显著差异。然而，SR 在 DFS 方面优于 RFA。
结论
对于 BCLC 极早期/早期 HCC 患者，SR 和 RFA 的 OS 无显著差异。然而，SR 在 DFS 方面优于 RFA。
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