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经动脉化疗栓塞联合射频消融后再次肝切除术治疗根治性切除术后复发性肝细胞癌:一项10年单中心比较研究

Transarterial Chemoembolization Combined With Radiofrequency Ablation Repeat Hepatectomy for Recurrent Hepatocellular Carcinoma After Curative Resection: A 10-Year Single-Center Comparative Study.

作者信息

Zheng Xin, Ren Yanqiao, Hu Hanqing, Qian Kun

机构信息

Department of Hepatopancreatobilary Surgery, The First College of Clinical Medical Sciences, China Three Gorges University, Yichang, China.

Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.

出版信息

Front Oncol. 2021 Sep 9;11:713432. doi: 10.3389/fonc.2021.713432. eCollection 2021.

DOI:10.3389/fonc.2021.713432
PMID:34568043
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8460128/
Abstract

BACKGROUND

The purpose of this study was to compare the efficacy and safety of transarterial chemoembolization (TACE) in combination with radiofrequency ablation (RFA) (TACE-RFA) and repeat hepatectomy in the treatment of recurrent hepatocellular carcinoma (HCC) after curative resection.

METHODS

This retrospective study evaluated consecutive medical records of patients who received either TACE-RFA or repeat hepatectomy between January 2010 and May 2021. Overall survival (OS), progression-free survival (PFS), and complications were compared.

RESULTS

Of the 2672 patients who received either TACE-RFA or repeat hepatectomy, 111 eligible patients were included in our study, 63 in the TACE-RFA group and 48 in the repeat hepatectomy group. The median OS was 38 months in the TACE-RFA group and 42 months in the repeat hepatectomy group, with no statistically difference between the two groups (=0.45). Meanwhile, there was also no statistically significant difference in PFS between the two groups (=0.634). Although both groups achieved similar outcomes, the rate of major complications was significantly higher in the repeat hepatectomy group (=0.003).

CONCLUSIONS

Patients with recurrent HCC in the TACE-RFA group and the repeat hepatectomy group had similar OS and PFS regardless of the patient's tumor diameter, but the TACE-RFA group was safer and more minimally invasive.

摘要

背景

本研究旨在比较经动脉化疗栓塞术(TACE)联合射频消融术(RFA)(TACE-RFA)与再次肝切除术治疗根治性切除术后复发性肝细胞癌(HCC)的疗效和安全性。

方法

本回顾性研究评估了2010年1月至2021年5月期间接受TACE-RFA或再次肝切除术患者的连续病历。比较总生存期(OS)、无进展生存期(PFS)和并发症。

结果

在接受TACE-RFA或再次肝切除术的2672例患者中,111例符合条件的患者纳入本研究,TACE-RFA组63例,再次肝切除术组48例。TACE-RFA组的中位OS为38个月,再次肝切除术组为42个月,两组之间无统计学差异(=0.45)。同时,两组的PFS也无统计学差异(=0.634)。尽管两组取得了相似的结果,但再次肝切除术组的主要并发症发生率显著更高(=0.003)。

结论

TACE-RFA组和再次肝切除术组的复发性HCC患者,无论肿瘤直径大小,OS和PFS相似,但TACE-RFA组更安全且微创性更强。

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Abdom Radiol (NY). 2020 Sep;45(9):2862-2870. doi: 10.1007/s00261-020-02584-6.
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Improved clinical outcome using transarterial chemoembolization combined with radiofrequency ablation for patients in Barcelona clinic liver cancer stage A or B hepatocellular carcinoma regardless of tumor size: results of a single-center retrospective case control study.经导管动脉化疗栓塞联合射频消融治疗巴塞罗那临床肝癌分期 A 或 B 期肝细胞癌患者的临床结局改善,无论肿瘤大小:单中心回顾性病例对照研究结果。
BMC Cancer. 2019 Oct 22;19(1):983. doi: 10.1186/s12885-019-6237-5.
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Transarterial chemoembolization combined with radiofrequency ablation for medium and large hepatocellular carcinoma: insufficient ablation is associated with intrahepatic distant metastasis and extrahepatic metastasis.
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Front Oncol. 2024 Apr 5;14:1283843. doi: 10.3389/fonc.2024.1283843. eCollection 2024.
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Radiological findings in non-surgical recurrent hepatocellular carcinoma: From locoregional treatments to immunotherapy.非手术复发性肝细胞癌的放射学表现:从局部区域治疗到免疫治疗。
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J Hepatol. 2018 Jul;69(1):182-236. doi: 10.1016/j.jhep.2018.03.019. Epub 2018 Apr 5.
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