Kwak Min Hwan, Lee Min Woo, Ko Seong Eun, Rhim Hyunchul, Kang Tae Wook, Song Kyoung Doo, Kim Jong Man, Choi Gyu-Seong
Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Department of Health Sciences and Technology, SAIHST, Sungkyunkwan University, Seoul, Korea.
Ultrasonography. 2022 Jul;41(3):543-552. doi: 10.14366/usg.21241. Epub 2022 Feb 9.
Radiofrequency ablation is a curative treatment option for very early-stage or earlystage hepatocellular carcinoma (HCC). However, percutaneous radiofrequency ablation (PRFA) for subphrenic tumors is technically challenging. Laparoscopic radiofrequency ablation (LRFA) has been used to overcome this disadvantage. This study compared the treatment outcomes between LRFA and PRFA for subphrenic HCC.
This retrospective study screened patients who underwent PRFA or LRFA for subphrenic HCC between 2013 and 2018. Therapeutic outcomes, including local tumor progression (LTP), intrahepatic distant recurrence (IDR), extrahepatic metastasis (EM), disease-free survival (DFS), and overall survival (OS), were compared between the two groups.
Thirty patients in the PRFA group and 23 patients in the LRFA group were included. LTP was observed in six patients in the PRFA group (20%), but in no patients in the LRFA group. The cumulative LTP rates at 1, 3, and 5 years were 3.7%, 23.4%, and 23.4%, respectively, in the PRFA group and 0.0% in the LRFA group (P=0.015). The IDR, EM, and DFS rates were not significantly different between the two groups (P=0.304, P=0.175, and P=0.075, respectively). The OS rates at 1, 3, and 5 years were 96.6%, 85.7%, and 71.6%, respectively, in the PRFA group and 100%, 95.7%, and 95.7%, respectively, in the LRFA group (P=0.049).
LRFA demonstrated better therapeutic outcomes than did PRFA for subphrenic tumors in terms of LTP and OS. Therefore, LRFA can be considered as the first-line treatment option for subphrenic HCC.
射频消融是极早期或早期肝细胞癌（HCC）的一种根治性治疗选择。然而，经皮射频消融（PRFA）治疗膈下肿瘤在技术上具有挑战性。腹腔镜射频消融（LRFA）已被用于克服这一缺点。本研究比较了LRFA和PRFA治疗膈下HCC的疗效。
这项回顾性研究筛选了2013年至2018年间接受PRFA或LRFA治疗膈下HCC的患者。比较两组的治疗结果，包括局部肿瘤进展（LTP）、肝内远处复发（IDR）、肝外转移（EM）、无病生存期（DFS）和总生存期（OS）。
PRFA组纳入30例患者，LRFA组纳入23例患者。PRFA组6例患者（20%）出现LTP，而LRFA组无患者出现。PRFA组1年、3年和5年的累积LTP率分别为3.7%、23.4%和23.4%，LRFA组为0.0%（P=0.015）。两组的IDR、EM和DFS率无显著差异（分别为P=0.304、P=0.175和P=0.075）。PRFA组1年、3年和5年的OS率分别为96.6%、85.7%和71.6%，LRFA组分别为100%、95.7%和95.7%（P=0.049）。
在LTP和OS方面，LRFA治疗膈下肿瘤的疗效优于PRFA。因此，LRFA可被视为膈下HCC的一线治疗选择。
