Department of Surgery, The University of Hong Kong, Queen Mary Hospital, 102 Pok Fu Lam Road, Hong Kong, L454, China.
World J Surg. 2012 Jan;36(1):151-6. doi: 10.1007/s00268-011-1323-0.
Tumor recurrence after resection of hepatocellular carcinoma is a common phenomenon. Re-resection and radiofrequency ablation (RFA) are good options for treating recurrent HCC. This study compared the efficacy of these two modalities in the treatment of intrahepatic HCC recurrence after hepatectomy.
From January 2001 to December 2008, a total of 179 patients developed intrahepatic HCC recurrence after hepatectomy. To treat the recurrence, 29 patients underwent re-resection and 45 patients had RFA. Patient characteristics, clinicopathologic data, and survival outcomes were reviewed.
Child-Pugh status, time to develop first recurrence (12.2 vs. 8.7 months), and recurrent tumor size (2.1 vs. 2.1 cm) were comparable for the two groups. Time to develop a second intrahepatic recurrence after re-resection and RFA was 5.9 and 4.0 months respectively. The 1-, 3-, and 5-year disease-free survival rates were 41.4%, 24.2%, and 24.2% after re-resection and 32.2%, 12.4%, and 9.3% after RFA (p = 0.14). The 1-, 3-, and 5-year overall survival rates were 89.7%, 56.5%, and 35.2% after re-resection and 83.7%, 43.1%, and 29.1% after RFA (p = 0.48). For the second recurrence, 33.3% of patients underwent a second round of RFA and 10.0% underwent a third resection.
The two treatment modalities attained similar survival benefits in the management of recurrent HCC after hepatectomy. The high repeatability of RFA and that it can be delivered percutaneously render it a preferred treatment option for selected patients.
肝癌切除术后肿瘤复发是一种常见现象。再次切除和射频消融（RFA）是治疗复发性肝癌的好方法。本研究比较了这两种方法治疗肝癌切除术后肝内 HCC 复发的疗效。
2001 年 1 月至 2008 年 12 月，共 179 例患者在肝切除术后发生肝内 HCC 复发。为治疗复发，29 例患者行再次切除术，45 例行 RFA。回顾患者特征、临床病理数据和生存结果。
两组患者的 Child-Pugh 状态、首次复发时间（12.2 个月 vs. 8.7 个月）和复发性肿瘤大小（2.1 厘米 vs. 2.1 厘米）相似。再次切除和 RFA 后发生第二次肝内复发的时间分别为 5.9 和 4.0 个月。再次切除后的 1、3 和 5 年无病生存率分别为 41.4%、24.2%和 24.2%，RFA 后分别为 32.2%、12.4%和 9.3%（p=0.14）。再次切除后的 1、3 和 5 年总生存率分别为 89.7%、56.5%和 35.2%，RFA 后分别为 83.7%、43.1%和 29.1%（p=0.48）。对于第二次复发，33.3%的患者接受了第二轮 RFA，10.0%的患者接受了第三次切除。
两种治疗方法在肝癌切除术后复发性 HCC 的治疗中均获得了相似的生存获益。RFA 的高重复性和经皮可操作性使其成为某些患者的首选治疗方法。
