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[75岁及以上肝硬化患者肝细胞癌经皮射频消融的结果]

[Results of percutaneous radiofrequency ablation of hepatocellular carcinoma in patients with cirrhosis aged 75 years and over].

作者信息

Lahbabi M, N'kontchou G, Aout M, Vicaud E, Ganne N, Trinchet J C, Seror O, Beaugrand M

机构信息

Centre hospitalier universitaire Hassan II, Fès, Morocco.

出版信息

Rev Med Interne. 2012 Mar;33(3):128-33. doi: 10.1016/j.revmed.2011.12.002. Epub 2012 Jan 4.

Abstract

PURPOSE

The objective of this study was to assess the results and tolerance of radiofrequency ablation in patients with cirrhosis and hepatocellular carcinoma (HCC) older than 75 years.

PATIENTS AND METHODS

Over a period of 9 years from January 2001, 235 patients with cirrhosis and 3 or less HCC≤5 cm of diameter were treated by radiofrequency ablation. Among them, 52 patients older than 75 years were selected for this study.

RESULTS

The mean age was 79.4±3. 5 years. There were 36 males, cirrhosis was classified Child-Pugh class A (n=52) related to alcohol (n=13), HCV infection (n=33), or other causes (n=6). The mean tumour diameter was 32.5±10.6 mm, and 14 patients had a multifocal HCC. A complete ablation was obtained in 50/52 patients (96%). No severe complication occurred. The estimated overall survival rates were 62%, 52% and 36% at 3 years, 4 years and 5 years, respectively; it was similar to those observed in patients younger than 75 years.

CONCLUSION

In patients with cirrhosis older than 75 years, radiofrequency ablation of 3 or less HCC≤5cm is well tolerated and survivals rates are similar to those of younger patients.

摘要

目的

本研究的目的是评估75岁以上肝硬化合并肝细胞癌(HCC)患者接受射频消融的效果及耐受性。

患者与方法

从2001年1月起的9年间,对235例肝硬化且直径小于或等于5 cm的3个及以下HCC患者进行了射频消融治疗。其中,52例75岁以上患者被选入本研究。

结果

平均年龄为79.4±3.5岁。男性36例,肝硬化根据Child-Pugh分级为A级(n = 52),病因包括酒精性(n = 13)、丙型肝炎病毒感染(n = 33)或其他原因(n = 6)。平均肿瘤直径为32.5±10.6 mm,14例患者有多灶性HCC。52例患者中有50例(96%)实现了完全消融。未发生严重并发症。3年、4年和5年的估计总生存率分别为62%、52%和36%;与75岁以下患者的生存率相似。

结论

在75岁以上的肝硬化患者中,对直径小于或等于5 cm的3个及以下HCC进行射频消融耐受性良好,生存率与年轻患者相似。

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