Kuo Yuan-Hung, Chung Kuan-Chih, Hung Chao-Hung, Lu Sheng-Nan, Wang Jing-Houng
Division of Hepato-Gastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
Department of Anesthesiology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
Kaohsiung J Med Sci. 2014 Nov;30(11):559-65. doi: 10.1016/j.kjms.2014.07.001. Epub 2014 Jul 28.
This study investigates the impact of general anesthesia (GA) on percutaneous radiofrequency ablation (RFA) of hepatocellular carcinoma (HCC). A total of 118 treatment-naïve HCC patients in Barcelona Clinic Liver Cancer curative stage were enrolled. Patients who underwent RFA with GA were designated as the GA group, and the others were identified as the non-GA group. All the percutaneous RFA procedures were performed by the same hepatologist. The GA group comprised 42 (44.1%) patients with 71 tumors (mean size, 2.53 cm) and the non-GA group had 66 patients (55.9%) with 90 tumors (mean size, 2.35 cm). Complete tumor ablation was achieved after one session in 92.3% of the 52 GA patients, and after one to three sessions in 92.4% of 66 non-GA patients. The GA group required significantly fewer RFA sessions to obtain a similar treatment effect (p < 0.001) and the duration of hospitalization was also shortened among the GA patients (4.4 ± 0.9 days vs. 5.1 ± 1.9 days, p = 0.044). The 2-year overall survival and recurrence-free survival rates were not significantly different between the two groups. Overall, performing RFA with GA can decrease the number of sessions required to achieve complete tumor ablation in early stage HCC patients and shorten the hospitalization duration.
本研究探讨全身麻醉（GA）对肝细胞癌（HCC）经皮射频消融（RFA）的影响。共纳入118例巴塞罗那临床肝癌根治期初治的HCC患者。接受GA下RFA治疗的患者被指定为GA组，其余患者被确定为非GA组。所有经皮RFA手术均由同一位肝病专家进行。GA组包括42例（44.1%）患者，共71个肿瘤（平均大小2.53 cm），非GA组有66例患者（55.9%），共90个肿瘤（平均大小2.35 cm）。52例GA患者中有92.3%在一次治疗后实现了肿瘤完全消融，66例非GA患者中有92.4%在一至三次治疗后实现了肿瘤完全消融。GA组获得相似治疗效果所需的RFA治疗次数显著更少（p < 0.001），且GA患者的住院时间也缩短（4.4±0.9天 vs. 5.1±1.9天，p = 0.044）。两组的2年总生存率和无复发生存率无显著差异。总体而言，在早期HCC患者中采用GA进行RFA可减少实现肿瘤完全消融所需的治疗次数，并缩短住院时间。
