Department of Radiology, The Second Affiliated Hospital of Southeast University, Southeast University, 1-1 Zhongfu Road, Nanjing, Jiangsu, 210003, China.
Department of Oncology, The Second Affiliated Hospital of Southeast University, Southeast University, 1-1 Zhongfu Road, Nanjing, Jiangsu, 210003, China.
Sci Rep. 2017 Mar 14;7:44583. doi: 10.1038/srep44583.
Computed tomography-guided radiofrequency ablation (CT-RFA) and laparoscopic RFA (L-RFA) have been used to treat intrahepatic recurrent small hepatocellular carcinoma (HCC) against the diaphragmatic dome. However, the therapeutic safety, efficacy, and hospital fee have never been compared between the two techniques due to scarcity of cases. In this retrospective study, 116 patients were divided into two groups with a total of 151 local recurrent HCC lesions abutting the diaphragm. We compared overall survival (OS), local tumor progression (LTP), postoperative complications, and hospital stay and fee between the two groups. Our findings revealed no significant differences in 5-year OS (36.7% vs. 44.6%, p = 0.4289) or 5-year LTP (73.3% vs. 67.9%, p = 0.8897) between CT-RFA and L-RFA. The overall hospital stay (2.8 days vs. 4.1 days, p < 0.0001) and cost (¥ 19217.6 vs. ¥ 25553.6, p < 0.0001) were significantly lower in the CT-RFA in comparison to that of L-RFA. In addition, we elaborated on the choice of percutaneous puncture paths depending on the locations of the HCC nodules and 11-year experience with CT-RFA. In conclusion, CT-RFA is a relatively easy and economic technique for recurrent small HCC abutting the diaphragm, and both CT-RFA and L-RFA are effective techniques.
计算机断层扫描引导下射频消融术（CT-RFA）和腹腔镜射频消融术（L-RFA）已被用于治疗膈顶附近的肝内复发性小肝细胞癌（HCC）。然而，由于病例稀少，这两种技术的治疗安全性、疗效和住院费用从未进行过比较。在这项回顾性研究中，将 116 名患者分为两组，共有 151 个局部复发性 HCC 病变紧贴膈肌。我们比较了两组患者的总生存率（OS）、局部肿瘤进展（LTP）、术后并发症以及住院时间和费用。我们的研究结果显示，两组患者的 5 年 OS（36.7% vs. 44.6%，p=0.4289）和 5 年 LTP（73.3% vs. 67.9%，p=0.8897）均无显著差异。与 L-RFA 相比，CT-RFA 的总住院时间（2.8 天 vs. 4.1 天，p<0.0001）和费用（¥19217.6 比 ¥25553.6，p<0.0001）显著降低。此外，我们根据 HCC 结节的位置详细阐述了经皮穿刺路径的选择，并分享了 11 年来 CT-RFA 的经验。总之，CT-RFA 是一种相对简单且经济的治疗紧贴膈肌的复发性小 HCC 的方法，CT-RFA 和 L-RFA 都是有效的技术。
