符合米兰标准的肝细胞癌微波消融与手术切除治疗的比较

Comparison of microwave ablation and surgical resection for treatment of hepatocellular carcinomas conforming to Milan criteria.

作者信息

Shi Jingxiang, Sun Quan, Wang Yijun, Jing Xiang, Ding Jianmin, Yuan Qiang, Ren Chaoyi, Shan Shigang, Wang Yandong, Du Zhi

机构信息

The Third Central Clinical College of Tianjin Medical University, Tianjin, China; Department of Hepatobiliary Surgery, The Third Central Hospital of Tianjin, Tianjin, China.

出版信息

J Gastroenterol Hepatol. 2014;29(7):1500-7. doi: 10.1111/jgh.12572.

DOI:10.1111/jgh.12572

PMID:24628534

Abstract

BACKGROUND AND AIM

To compare the efficacy of microwave ablation (MWA) and surgical resection (RES) in the treatment of hepatocellular carcinoma (HCC) conforming to Milan criteria.

METHODS

Two hundred twenty-four patients met the inclusion criteria and were enrolled in the study. One hundred and seventeen patients received MWA, and 107 patients underwent RES. The primary endpoints were overall survival (OS) and disease-free survival (DFS).

RESULTS

The 1-, 3-, and 5-year OS rates were 94%, 70%, 52% for the MWA group and 94%, 72%, 60% for the RES group (P = 0.513). The corresponding DFS rates for the two groups were 77%, 38%, 18% and 85%, 57%, 31% (P = 0.005). In subgroup analyses of patients with solitary HCC ≤ 3 cm, there were no significant differences in OS rates and DFS rates between the two groups (P = 0.577 and P = 0.140). For patients with solitary HCC 3 to 5 cm, there was no significant differences in OS rates between the two groups (P = 0.820), the DFS rates was significantly higher in the RES group than in the MWA group (P = 0.014).

CONCLUSIONS

MWA results in lower DFS rates than RES for HCC conforming to Milan criteria. However, the OS rates are comparable between the two therapies. For solitary HCC ≤ 3 cm, MWA is as effective as RES.

摘要

背景与目的

比较微波消融（MWA）与手术切除（RES）治疗符合米兰标准的肝细胞癌（HCC）的疗效。

方法

224例患者符合纳入标准并纳入本研究。117例患者接受MWA，107例患者接受RES。主要终点为总生存期（OS）和无病生存期（DFS）。

结果

MWA组1年、3年和5年OS率分别为94%、70%、52%，RES组分别为94%、72%、60%（P = 0.513）。两组相应的DFS率分别为77%、38%、18%和85%、57%、31%（P = 0.005）。在≤3 cm的孤立性HCC患者亚组分析中，两组的OS率和DFS率无显著差异（P = 0.577和P = 0.140）。对于3至5 cm的孤立性HCC患者，两组的OS率无显著差异（P = 0.820），RES组的DFS率显著高于MWA组（P = 0.014）。