Sheng Li, Wang Yiqi, Jun Dong, Peihong Wu
Zhonghua Zhong Liu Za Zhi. 2015 Apr;37(4):301-7.
To compare the effectiveness of percutaneous microwave ablation ( MWA) versus hepatectomy for multifocal hepatocellular carcinoma.
From August 2002 to March 2012, one hundred and twenty-two patients with multifocal hepatocellular carcinoma (diameters 1 to 7 cm, 2 to 4 lesions) were treated by either complete MWA or radical hepatectomy, and their clinical data were collected and analyzed.The patients were divided into MWA group (n = 50) and resection group (n = 72), and the resection group was matched by MWA group based on clinical parameters. The survival and complications in the two groups were compared.
The overall 1-, 3- and 5-year survival rates were 100.0%, 73.0% and 62.0%, respectively, in the MWA group, and 80.0%, 56.0%, and 41.0%, respectively, in the resection group (P < 0.05). The corresponding recurrence-free survival rates were 88.0%, 63.0%, and 52.0% in the MWA group, and 68.0%, 45.0%, and 36.0%, respectively, in the resection group (P< 0.05). The multivariate Cox regression analysis indicated that albumin level, performance status, treatment modality, and tumor size were independent prognostic factors.
Compared with hepatectomy, percutaneous microwave ablation is a minimally invasive and reproducible procedure, and can improve the survival in patients with multifocal hepatocellular carcinoma.
比较经皮微波消融术(MWA)与肝切除术治疗多灶性肝细胞癌的疗效。
收集2002年8月至2012年3月期间122例多灶性肝细胞癌患者(肿瘤直径1至7 cm,病灶2至4个)的临床资料,这些患者分别接受了完整的MWA治疗或根治性肝切除术。将患者分为MWA组(n = 50)和切除组(n = 72),切除组根据临床参数与MWA组进行匹配。比较两组患者的生存率和并发症情况。
MWA组的1年、3年和5年总生存率分别为100.0%、73.0%和62.0%,切除组分别为80.0%、56.0%和41.0%(P < 0.05)。MWA组相应的无复发生存率分别为88.0%、63.0%和52.0%,切除组分别为68.0%、45.0%和36.0%(P < 0.05)。多因素Cox回归分析表明,白蛋白水平、体能状态、治疗方式和肿瘤大小是独立的预后因素。
与肝切除术相比,经皮微波消融术是一种微创且可重复的手术方法,可提高多灶性肝细胞癌患者的生存率。