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射频消融联合经导管动脉化疗栓塞治疗 2 至 5cm 直径的单发肝细胞癌:与手术切除的比较。

Radiofrequency ablation combined with transcatheter arterial chemoembolization for the treatment of single hepatocellular carcinoma of 2 to 5 cm in diameter: comparison with surgical resection.

机构信息

Department of Radiology, Chonnam National University Hwasun Hospital, Hwasun 519-763, Korea.

出版信息

Korean J Radiol. 2013 Jul-Aug;14(4):626-35. doi: 10.3348/kjr.2013.14.4.626. Epub 2013 Jul 17.

Abstract

OBJECTIVE

To compare the effectiveness of radiofrequency ablation (RFA) combined with transcatheter arterial chemoembolization (TACE) with surgical resection in patients with a single hepatocellular carcinoma (HCC) ranging from 2 to 5 cm.

MATERIALS AND METHODS

The study participants were enrolled over a period of 29 months and were comprised of 37 patients in a combined therapy group and 47 patients in a surgical resection group. RFA was performed the day after TACE, and surgical resection was performed by open laparotomy. The two groups were compared with respect to the length of hospital stay, rates of major complication, and rates of recurrence-free and overall survival.

RESULTS

Major complications occurred more frequently in the surgical resection group (14.9%) than in the combined therapy group (2.7%). However, there was no statistical significance (p = 0.059). The rates of recurrence-free survival at 1, 2, 3 and 4 years were similar between the combined therapy group (89.2%, 75.2%, 69.4% and 69.4%, respectively) and the surgical resection group (81.8%, 68.5%, 68.5% and 65%, respectively) (p = 0.7962, log-rank test). The overall survival rates at 1, 2, 3 and 4 years were also similar between groups (97.3%, 86.5%, 78.4% and 78.4%, respectively, in the combined therapy group, and 95.7%, 89.4%, 84.3% and 80.3%, respectively, in the surgical resection group) (p = 0.6321, log-rank test).

CONCLUSION

When compared with surgical resection for the treatment of a single HCC ranging from 2 to 5 cm, RFA combined with TACE shows similar results in terms of recurrence-free and overall survival rates.

摘要

目的

比较射频消融(RFA)联合肝动脉化疗栓塞术(TACE)与手术切除治疗单个 2 至 5cm 肝癌的疗效。

材料与方法

本研究共纳入 29 个月内的 37 例联合治疗组和 47 例手术切除组患者。TACE 后第 2 天行 RFA,手术切除采用开腹手术。比较两组患者的住院时间、主要并发症发生率、无复发生存率和总生存率。

结果

手术切除组主要并发症发生率(14.9%)高于联合治疗组(2.7%),但差异无统计学意义(p=0.059)。联合治疗组和手术切除组 1、2、3、4 年无复发生存率分别为 89.2%、75.2%、69.4%和 69.4%,68.5%、68.5%、65%和 65%(p=0.7962,log-rank 检验)。两组 1、2、3、4 年总生存率分别为 97.3%、86.5%、78.4%和 78.4%,95.7%、89.4%、84.3%和 80.3%(p=0.6321,log-rank 检验)。

结论

与手术切除相比,RFA 联合 TACE 治疗单个 2 至 5cm 肝癌在无复发生存率和总生存率方面具有相似的疗效。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4929/3725357/450ef64d5d3b/kjr-14-626-g001.jpg

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