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微波消融改善接受肝切除术的肝细胞癌患者的预后。

Microwave-Assisted Ablation Improves the Prognosis of Patients With Hepatocellular Carcinoma Undergoing Liver Resection.

作者信息

Shen Haiyuan, Zhou Shu, Lou Yun, Gao Yangjuan, Cao Shouji, Wu Du, Li Guoqiang

机构信息

1 Department of Liver Surgery, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu Province, China.

2 Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu Province, China.

出版信息

Technol Cancer Res Treat. 2018 Jan 1;17:1533033818785980. doi: 10.1177/1533033818785980.

Abstract

OBJECTIVE

We evaluated microwave-assisted liver resection for hepatocellular carcinoma.

PATIENTS AND METHODS

We enrolled 79 patients in this study, and microwave ablation was used for liver resection. Patients were randomized to group A (50.6%; n = 40), liver resection without microwave ablation, or group B (49.4%; n = 39), liver resection performed using microwave ablation. Data were analyzed for statistical significance.

RESULTS

Of the participants enrolled, 60 were male, and the participant's average age was 59.32 ± 10.34 years. The mean overall tumor diameter was 4.39 (2.00) cm, and this did not differ between groups. Intraoperative blood loss in group B was significantly less than that in group A ( P < .001). No differences were reported between the 2 groups regarding surgical time ( P = .914), postoperative morbidity ( P = .718), and late postoperative complications ( P = .409). Postoperative drainage volume for group B was less than that of group A on the first ( P = .005) and third ( P = .019) day after surgery. The time of postoperative hospitalization in group B was significantly shorter than that in group A ( P < .001). Local recurrence was noted in 18.99% of cases (n = 15) in group B, which is less than that of group A ( P = 0.047), while in group B distant metastasis is less but not statistically significant ( P = 0.061). The 1-year and 3-year cumulative survival rates were 57% and 93.7%, respectively.

CONCLUSIONS

The curative effects of liver resection combined with microwave ablation during operation are superior to only liver resection in the treatment of primary liver cancer.

摘要

目的

我们评估了微波辅助肝切除术治疗肝细胞癌的效果。

患者与方法

本研究纳入79例患者,采用微波消融辅助肝切除术。患者被随机分为A组(50.6%;n = 40),即未进行微波消融的肝切除术组,或B组(49.4%;n = 39),即采用微波消融进行肝切除术的组。对数据进行统计学显著性分析。

结果

纳入的参与者中,60例为男性,参与者的平均年龄为59.32±10.34岁。肿瘤平均总直径为4.39(2.00)cm,两组之间无差异。B组术中出血量显著少于A组(P <.001)。两组在手术时间(P =.914)、术后发病率(P =.718)和术后晚期并发症(P =.409)方面无差异。B组术后第一天(P =.005)和第三天(P =.019)的引流量少于A组。B组术后住院时间显著短于A组(P <.001)。B组局部复发率为18.99%(n = 15),低于A组(P = 0.047),而B组远处转移较少但无统计学显著性(P = 0.061)。1年和3年累积生存率分别为57%和93.7%。

结论

手术中肝切除联合微波消融治疗原发性肝癌的疗效优于单纯肝切除。

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