Radiofrequency ablation for hepatocellular carcinoma: 10-year outcome and prognostic factors.
Radiofrequency ablation for hepatocellular carcinoma: 10-year outcome and prognostic factors.
复制标题
DOI：
10.1038/ajg.2011.425
复制
发表时间：
2012-04
影响因子：
9.8
通讯作者：
Koike, Kazuhiko
中科院分区：
文献类型：
--
作者：
Shiina, Shuichiro;Tateishi, Ryosuke;Arano, Toru;Uchino, Koji;Enooku, Kenichiro;Nakagawa, Hayato;Asaoka, Yoshinari;Sato, Takahisa;Masuzaki, Ryota;Kondo, Yuji;Goto, Tadashi;Yoshida, Haruhiko;Omata, Masao;Koike, Kazuhiko
射频消融术(RFA)广泛应用于肝细胞癌(HCC)。然而，还没有关于RFA十年成果的报告。这项研究的目的是报告一个三级转诊中心连续10年的病例系列。我们对1,170名原发性肝癌患者进行了2,982次RFA治疗，并分析了收集的数据库。最终的计算机断层扫描图像显示，在对1,170名原发性肝癌患者进行的2,982次治疗中，有2,964次(99.4%)肿瘤完全消融。中位随访期38.2个月，5年和10年生存率分别为60.2%(95%可信区间：56.7-63.9%)和27.3%(95%可信区间：21.5-34.7%)。多因素分析显示，年龄、丙型肝炎病毒抗体、ChildPugh分级、肿瘤大小、肿瘤个数、血清DES-γ-羧基-凝血酶原、血清凝集素反应性甲胎蛋白(α-L3)水平与生存期显著相关。5年和10年局部肿瘤进展率均为3.2%(95%可信区间：2.1-4.3%)。单独血清DCP水平与局部肿瘤进展显著相关。5年和10年远期复发率分别为74.8%(95%CI：71.8-77.8%)和80.8%(95%CI：77.4-84.3%)。抗-丙型肝炎病毒抗体、Child-Pugh分级、血小板计数、肿瘤大小、肿瘤个数、血清AFP水平、血清DCP水平与远处复发显著相关。并发症67例(2.2%)，死亡1例(0.03%)。RFA可局部治愈肝细胞癌，可使患者存活长达10年，是一种安全的治疗方法。RFA可能是选择早期肝癌患者的一线治疗方法。
Radiofrequency ablation (RFA) is widely performed for hepatocellular carcinoma (HCC). However, there has been no report on 10-year outcome of RFA. The objective of this study was to report a 10-year consecutive case series at a tertiary referral center. We performed 2,982 RFA treatments on 1,170 primary HCC patients and analyzed a collected database. Final computed tomography images showed complete tumor ablation in 2,964 (99.4%) of 2,982 treatments performed for the 1,170 primary HCC patients. With a median follow-up of 38.2 months, 5- and 10-year survival rates were 60.2% (95% confidence interval (CI): 56.7–63.9%) and 27.3% (95% CI: 21.5–34.7%), respectively. Multivariate analysis demonstrated that age, antibody to hepatitis C virus (anti-HCV), Child-Pugh class, tumor size, tumor number, serum des-γ-carboxy-prothrombin (DCP) level, and serum lectin-reactive α-fetoprotein level (AFP-L3) were significantly related to survival. Five- and 10-year local tumor progression rates were both 3.2% (95% CI: 2.1–4.3%). Serum DCP level alone was significantly related to local tumor progression. Five- and 10-year distant recurrence rates were 74.8% (95% CI: 71.8–77.8%) and 80.8% (95% CI: 77.4–84.3%), respectively. Anti-HCV, Child-Pugh class, platelet count, tumor size, tumor number, serum AFP level, and serum DCP level were significantly related to distant recurrence. There were 67 complications (2.2%) and 1 death (0.03%). RFA could be locally curative for HCC, resulting in survival for as long as 10 years, and was a safe procedure. RFA might be a first-line treatment for selected patients with early-stage HCC.
登录
查看更多内容
影响因子：
29.4
作者：
FRANCO, D;CAPUSSOTTI, L;DELLEPIANE, M
通讯作者：
DELLEPIANE, M
影响因子：
5.2
作者：
Hanazaki, K;Kajikawa, S;Amano, J
通讯作者：
Amano, J
影响因子：
19.7
作者：
Goldberg, SN;Grassi, CJ;Silverman, SG
通讯作者：
Silverman, SG
影响因子：
2.9
作者：
Hong, SN;Lee, SY;Joh, JW
通讯作者：
Joh, JW
影响因子：
5.9
作者：
Choi, Dongil;Lim, Hyo K.;Yoo, Byung Chul
通讯作者：
Yoo, Byung Chul