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射频消融和/或经动脉化疗栓塞术后复发性肝细胞癌的挽救性肝切除术:一项倾向评分匹配分析

Salvage Hepatectomy for Recurrent Hepatocellular Carcinoma after Radiofrequency Ablation and/or Transcatheter Arterial Chemoembolization: A Propensity Score-Matched Analysis.

作者信息

Orimo Tatsuya, Kamiyama Toshiya, Yokoo Hideki, Wakayama Kenji, Shimada Shingo, Einama Takahiro, Kamachi Hirofumi, Taketomi Akinobu

机构信息

Department of Gastroenterological Surgery I, Hokkaido University Graduate School of Medicine, Sapporo, Japan.

出版信息

Dig Surg. 2018;35(5):427-434. doi: 10.1159/000480521. Epub 2017 Sep 14.


DOI:10.1159/000480521
PMID:28903105
Abstract

AIM: We aimed to evaluate the short- and long-term surgical outcomes of salvage hepatectomy for recurrent hepatocellular carcinoma (HCC) after radiofrequency ablation (RFA) and/or transcatheter arterial chemoembolization (TACE). METHODS: We reviewed the surgical outcomes of 90 recurrent HCC patients after RFA and/or TACE (salvage group) and 490 HCC patients without preoperative treatment (primary group). We performed 1:1 propensity score matching (PSM) between the 2 groups and matched 87 patients in each group. RESULTS: Before PSM, the salvage group was pathologically more advanced than the primary group. After PSM, there were no significant differences in the clinicopathological features between the groups. The outcomes of propensity score-matched groups were compared and there was no statistically significant difference between the 2 groups regarding perioperative outcomes and survival. Univariate and multivariate analyses of propensity score-matched HCC patients revealed that stage, tumor size, differentiation, and portal vein invasion were independent prognostic factors for survival. Preoperative RFA and/or TACE was not a prognostic factor in a propensity score-matched cohort. CONCLUSIONS: The short- and long-term surgical outcomes of the primary and salvage groups were similar under the matched clinicopathological background. Salvage hepatectomy might be an acceptable treatment for recurrent HCC patients after RFA and/or TACE.

摘要

目的:我们旨在评估经射频消融(RFA)和/或经动脉化疗栓塞(TACE)后复发肝细胞癌(HCC)挽救性肝切除的短期和长期手术效果。 方法:我们回顾了90例RFA和/或TACE术后复发HCC患者(挽救组)以及490例未接受术前治疗的HCC患者(原发组)的手术效果。我们在两组之间进行了1:1倾向评分匹配(PSM),每组匹配87例患者。 结果:在PSM之前,挽救组在病理上比原发组更晚期。PSM之后,两组之间的临床病理特征无显著差异。比较倾向评分匹配组的结果,两组在围手术期结局和生存率方面无统计学显著差异。对倾向评分匹配的HCC患者进行单因素和多因素分析显示,分期、肿瘤大小、分化程度和门静脉侵犯是生存的独立预后因素。术前RFA和/或TACE在倾向评分匹配队列中不是预后因素。 结论:在匹配的临床病理背景下,原发组和挽救组的短期和长期手术效果相似。挽救性肝切除可能是RFA和/或TACE术后复发HCC患者的一种可接受的治疗方法。

相似文献

[1]
Salvage Hepatectomy for Recurrent Hepatocellular Carcinoma after Radiofrequency Ablation and/or Transcatheter Arterial Chemoembolization: A Propensity Score-Matched Analysis.

Dig Surg. 2018

[2]
Combined transcatheter arterial chemoembolization and radiofrequency ablation versus hepatectomy for recurrent hepatocellular carcinoma after initial surgery: a propensity score matching study.

Eur Radiol. 2018-3-13

[3]
Transcatheter arterial chemoembolization alone or combined with ablation for recurrent intermediate-stage hepatocellular carcinoma: a propensity score matching study.

J Cancer Res Clin Oncol. 2020-5-25

[4]
Efficacy of combination therapy with transcatheter arterial chemoembolization and radiofrequency ablation for intermediate-stage hepatocellular carcinoma.

Scand J Gastroenterol. 2018-12

[5]
The role of adjuvant transcatheter arterial chemoembolization following repeated curative resection/ablation for hepatocellular carcinoma with early recurrence: a propensity score matching analysis.

BMC Cancer. 2024-5-22

[6]
Comparison of overall survival on surgical resection versus transarterial chemoembolization with or without radiofrequency ablation in intermediate stage hepatocellular carcinoma: a propensity score matching analysis.

BMC Gastroenterol. 2020-4-10

[7]
Efficacy of radiofrequency ablation compared with transarterial chemoembolization for the treatment of recurrent hepatocellular carcinoma: a comparative survival analysis.

HPB (Oxford). 2016-1

[8]
The 10-year Survival Analysis of Radiofrequency Ablation for Solitary Hepatocellular Carcinoma 5 cm or Smaller: Primary versus Recurrent HCC.

Radiology. 2021-8

[9]
Clinical efficacy of postoperative adjuvant transcatheter arterial chemoembolization on hepatocellular carcinoma.

World J Surg Oncol. 2016-4-2

[10]
Factors predicting long-term outcomes of early-stage hepatocellular carcinoma after primary curative treatment: the role of surgical or nonsurgical methods.

BMC Cancer. 2021-3-8

引用本文的文献

[1]
Liver resection in patients with a history of local ablation for hepatocellular carcinoma has the risk of poor survival and serosal invasion.

Ann Gastroenterol Surg. 2024-11-18

[2]
Radiofrequency ablation combined with transcatheter arterial chemoembolization for recurrent liver cancer.

World J Gastrointest Surg. 2024-6-27

[3]
Short-Term and Long-Term Curative Effect of Partial Hepatectomy on Ruptured Hemorrhage of Primary Liver Cancer after TAE.

Emerg Med Int. 2022-7-5

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