Gastroenterology Center, Ehime Prefectural Central Hospital, Matsuyama, Japan,
Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Toon, Japan.
Oncology. 2019;96(5):242-251. doi: 10.1159/000496225. Epub 2019 Mar 20.
AIM/BACKGROUND: In HCC patients with multiple tumors in separate segments, monotherapy with surgical resection is often difficult when the estimated residual liver volume after surgery is thought to be inadequate. We evaluated the usefulness of resection combined with low invasive radiofrequency ablation (RFA) for treatment of such cases.
MATERIALS/METHODS: We analyzed 115 HCC patients with countable multiple tumors (≤5) without vascular invasion and/or extrahepatic metastasis, and treated solely with resection (SR group: n = 82), or with both resection and RFA (Comb group: n = 33) from January 2000 to December 2017. Clinical characteristics, overall survival rate (OSR), and disease-free survival rate (DFSR) were analyzed in a retrospective manner.
There were 88 males (76.5%) and the average age of all patients was 67.8 ± 8.9 years. The average number of tumors and average maximum tumor size were 2.4 ± 0.7 and 4.1 ± 2.1 cm, respectively. Forty-two (36.5%) patients were classified as beyond up-to-7 criteria. The 3- and 5-year OSRs in the SR group were 82.0 and 67.0%, respectively, and in the Comb group were 75.2 and 65.6%, respectively (p = 0.244), while the 3- and 5-year DFSRs in the SR group were 45.2 and 28.0%, respectively, and those in the Comb group were 37.3 and 23.3%, respectively (p = 0.257).
The combination of surgical resection and complementary RFA may be an effective strategy for treating HCC patients with countable multiple tumors, who are otherwise difficult to treat with surgical resection or RFA alone.
目的/背景：对于多个肿瘤位于不同肝段且预估术后剩余肝脏体积不足的 HCC 患者，单纯手术切除往往难以实施。我们评估了联合手术切除与微创射频消融（RFA）治疗此类病例的有效性。
材料/方法：我们分析了 2000 年 1 月至 2017 年 12 月期间，115 例无血管侵犯和/或肝外转移、且可计数的≤5 个肿瘤的 HCC 患者，单纯接受手术切除（SR 组，n=82）或手术切除联合 RFA（Comb 组，n=33）的治疗情况。回顾性分析了临床特征、总生存率（OSR）和无病生存率（DFSR）。
患者中男性 88 例（76.5%），平均年龄 67.8±8.9 岁。肿瘤数量和最大肿瘤直径的平均值分别为 2.4±0.7 个和 4.1±2.1cm。42 例（36.5%）患者超出 up-to-7 标准。SR 组的 3 年和 5 年 OSR 分别为 82.0%和 67.0%，Comb 组分别为 75.2%和 65.6%（p=0.244），SR 组的 3 年和 5 年 DFSR 分别为 45.2%和 28.0%，Comb 组分别为 37.3%和 23.3%（p=0.257）。
对于难以单独接受手术切除或 RFA 治疗的可计数多个肿瘤的 HCC 患者，手术切除联合补充性 RFA 可能是一种有效的治疗策略。
