Minimal Invasion Therapy Department 1, Eastern Hepatobiliary Surgery Hospital, Shanghai, China.
Ann Surg Oncol. 2013 Oct;20(11):3596-602. doi: 10.1245/s10434-013-3035-1. Epub 2013 May 29.
Repeated hepatic resection (HR) and thermal ablation therapy (TAT) are increasingly being used to treat recurrent intrahepatic cholangiocarcinoma (RICC). This study compared the efficacy and safety of these procedures for RICC treatment.
Patients were studied retrospectively after curative resection of RICCs by repeated HR (n = 32) or TAT (n = 77). Treatment effectiveness and prognosis were compared between the two treatment groups.
The repeated HR and TAT groups did not differ in their overall survival (OS; p = 0.996) or disease-free survival (DFS; p = 0.692) rates. However, among patients with recurrent tumors >3 cm in diameter, patients in the repeated HR group had a higher OS rate than patients in the TAT group (p = 0.037). The number of recurrent tumors and the recurrence interval were significant prognostic factors for OS. The major complications incidence rate was greater in the repeated HR group than in the TAT group (p < 0.001).
Repeated HR and TAT are both effective treatments for RICC with similar overall efficacies. TAT should be preferred in any cases when the RICC is ≤3 cm in diameter and technically feasible. However, for large tumors (>3 cm), repeated HR may be a better choice.
重复肝切除术（HR）和热消融治疗（TAT）越来越多地用于治疗复发性肝内胆管癌（RICC）。本研究比较了这些方法治疗 RICC 的疗效和安全性。
对 RICC 根治性切除后行重复 HR（n=32）或 TAT（n=77）治疗的患者进行回顾性研究。比较两组治疗效果和预后。
重复 HR 和 TAT 组患者的总生存期（OS；p=0.996）和无病生存期（DFS；p=0.692）无差异。然而，在复发性肿瘤直径>3cm 的患者中，重复 HR 组患者的 OS 率高于 TAT 组（p=0.037）。肿瘤复发数量和复发间隔是影响 OS 的重要预后因素。重复 HR 组的主要并发症发生率高于 TAT 组（p<0.001）。
重复 HR 和 TAT 均是 RICC 的有效治疗方法，整体疗效相似。当 RICC 直径≤3cm 且技术可行时，应优先选择 TAT。然而，对于大肿瘤（>3cm），重复 HR 可能是更好的选择。
