Yune Yongwoo, Kim Seokwhan, Song Insang, Chun Kwangsik
Department of surgery, Chungnam National University Hospital, Daejeon, Korea.
Korean J Hepatobiliary Pancreat Surg. 2015 Nov;19(4):173-80. doi: 10.14701/kjhbps.2015.19.4.173. Epub 2015 Nov 30.
BACKGROUNDS/AIMS: To compare the clinical outcomes of intraoperative radiofrequency ablation (RFA) and non-anatomical hepatic resection (NAHR) for small hepatocellular carcinoma (HCC).
From February 2007 to January 2015, clinical outcomes of thirty four patients with HCC receiving RFA or NAHR were compared, retrospectively.
There was no difference of patient and tumor characteristic between the two groups that received RFA or NAHR. The 1, 2, and 3-year recurrence rates following RFA were 32.2%, 32.2% and 59.3% respectively, and 6.7%, 33.3% and 33.3% following NAHR respectively (p=0.287). The 1, 2 and 3-year overall survival (OS) rates following RFA were 100%, 88.9% and 76.2% respectively, and 100%, 85.6% and 85.6%, respectively, following NAHR (p=0.869). We did not find a definite statistical difference in recurrence rate and OS rate between the two groups. In the multivariate analysis, number of tumor was an independent prognostic factor for recurrence and albumin was an independent prognostic factor for OS.
We recommend non-anatomical hepatic resection rather than intraoperative RFA in small sized HCC, due to a higher recurrence rate in intraoperative RFA. Intraoperative RFA was inferior to non-anatomical hepatic resection in terms of recurrence rate. We need to select the optimal treatment considering liver function and possibility of recurrence.
背景/目的:比较术中射频消融(RFA)与非解剖性肝切除术(NAHR)治疗小肝细胞癌(HCC)的临床疗效。
回顾性比较2007年2月至2015年1月期间接受RFA或NAHR治疗的34例HCC患者的临床疗效。
接受RFA或NAHR的两组患者及肿瘤特征无差异。RFA术后1、2、3年复发率分别为32.2%、32.2%和59.3%,NAHR术后分别为6.7%、33.3%和33.3%(p=0.287)。RFA术后1、2、3年总生存率(OS)分别为100%、88.9%和76.2%,NAHR术后分别为100%、85.6%和85.6%(p=0.869)。两组复发率和OS率未发现明确统计学差异。多因素分析中,肿瘤数量是复发的独立预后因素,白蛋白是OS的独立预后因素。
由于术中RFA复发率较高,对于小肝癌,推荐非解剖性肝切除术而非术中RFA。术中RFA在复发率方面劣于非解剖性肝切除术。我们需要综合考虑肝功能和复发可能性来选择最佳治疗方案。