Department of Surgery, Pamela Youde Nethersole Eastern Hospital, 3 Lok Man Road, Chai Wan, Hong Kong SAR, China.
Int J Surg. 2013;11(1):77-80. doi: 10.1016/j.ijsu.2012.11.019. Epub 2012 Dec 6.
To compare the results of radiofrequency ablation (RFA) with hepatic resection in the treatment of hepatocellular carcinoma (HCC) within the Milan criteria.
A nonrandomized comparative study was performed with 111 consecutive patients who underwent laparoscopic RFA (n = 31) or curative hepatic resection (n = 80) for HCC within Milan criteria.
Procedure related complications were less often and severe after RFA than resection (3.2% vs. 25%). There was no significant difference in hospital mortality (0% vs. 3.8%). Hospital stay was significantly shorter in the RFA group than in the resection group (mean, 3.8 vs. 6.8 days). The 1-, 3-, and 5-year disease-free survival rates for the RFA group and the resection group were 76%, 40%, 40% and 76%, 60%, 60%, respectively. Disease-free survival was significantly lower in the RFA group than in the resection group. The corresponding 1-, 3-, and 5-year overall survival rates for the RFA group and the resection group were 100%, 92%, 84%, and 92%, 75%, 71%, respectively. The overall survival for RFA and resection were not significantly different.
Our result showed comparable overall survival between RFA and surgery, although RFA was associated with a significantly higher tumor recurrence rate. RFA had the advantages over surgical resection in being less invasive and having lower morbidity.
比较射频消融（RFA）与肝切除术治疗米兰标准内肝细胞癌（HCC）的结果。
对 111 例连续接受腹腔镜 RFA（n = 31）或根治性肝切除术（n = 80）治疗米兰标准内 HCC 的患者进行非随机对照研究。
RFA 后与切除术相关的并发症发生率较低且严重程度较轻（3.2% vs. 25%）。住院死亡率无显著差异（0% vs. 3.8%）。RFA 组的住院时间明显短于切除术组（平均 3.8 天 vs. 6.8 天）。RFA 组和切除术组的 1 年、3 年和 5 年无疾病生存率分别为 76%、40%、40%和 76%、60%、60%。RFA 组无疾病生存率明显低于切除术组。RFA 组和切除术组的 1 年、3 年和 5 年总生存率分别为 100%、92%、84%和 92%、75%、71%。RFA 和手术的总生存率无显著差异。
我们的结果表明，RFA 与手术的总生存率相当，尽管 RFA 与更高的肿瘤复发率相关。RFA 具有创伤小、发病率低的优点，优于手术切除。
