Radiofrequency ablation of hepatocellular cancer in 110 patients with cirrhosis
Radiofrequency ablation of hepatocellular cancer in 110 patients with cirrhosis
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DOI：
10.1097/00000658-200009000-00010
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发表时间：
2000-09-01
影响因子：
9
通讯作者：
Vallone, P
中科院分区：
文献类型：
--
作者：
Curley, SA;Izzo, F;Vallone, P
目的确定肝硬化和不可切除的肝细胞癌（HCC）患者射频消融（RFA）的治疗效果、安全性、局部肿瘤控制和并发症。背景数据摘要大多数HCC患者由于肿瘤大小、位置或与肝硬化相关的肝功能障碍而不适合切除，RFA是一种技术，允许在原位破坏的肿瘤通过局部tissue heating.Methods肝硬化和HCC（儿童A级，50; B，31; C，29）的110例患者进行了治疗，在一项前瞻性研究中使用RFA。采用开腹手术、腹腔镜或经皮入路，在超声引导下将射频针电极置入肝肿瘤内，对患者进行射频消融治疗。所有患者均定期随访，以检测治疗相关的并发症或复发diseas.Results所有110例患者随访至少12个月后RFA（中位数随访19个月）。分别对76例（69%）和34例（31%）患者进行了经皮或术中RFA。共有149个离散的HCC肿瘤结节接受了RFA治疗。经腹手术治疗的肿瘤中位直径（2.8 cm）小于开腹手术治疗的肿瘤中位直径（4.6 cm）。4名患者（3.6%）在RFA部位发生局部肿瘤复发;所有4名患者随后在肝脏其他区域发生复发性HCC。50例患者（45.5%）发生了新的肝脏肿瘤或肝外转移，但56例患者（50.9%）没有复发的证据。有没有治疗相关的死亡，但并发症发生在14例（12.7%）后RFA.Conclusions肝硬化和HCC患者，RFA产生有效的局部控制疾病的患者中的一个显着比例，可以安全地进行并发症最少。
Objective To determine the treatment efficacy, safety, local tumor control, and complications related to radiofrequency ablation (RFA) in patients with cirrhosis and unresectable hepatocellular carcinoma (HCC),Summary Background Data Most patients with HCC are not candidates for resection because of tumor size, location, or hepatic dysfunction related to cirrhosis, RFA is a technique that permits in situ destruction of tumors by means of local tissue heating.Methods One hundred ten patients with cirrhosis and HCC (Child class A, 50; B, 31; C, 29) were treated during a prospective study using RFA. Patients were treated with RFA using an open laparotomy, laparoscopic, or percutaneous approach with ultrasound guidance to place the RF needle electrode into the hepatic tumors. All patients were followed up at regular intervals to detect treatment-related complications or recurrence of disease.Results All 110 patients were followed up for at least 12 months after RFA (median follow-up 19 months). Percutaneous or intraoperative RFA was performed in 76 (69%) and 34 patients (31%), respectively. A total of 149 discrete HCC tumor nodules were treated with RFA. The median diameter of tumors treated percutaneously (2.8 cm) was smaller than that of lesions treated during laparotomy (4.6 cm). Local tumor recurrence at the RFA site developed in four patients (3.6%); recurrent HCC subsequently developed in other areas of the liver in all four. New liver tumors or extrahepatic metastases developed in 50 patients (45.5%), but 56 patients (50.9%) had no evidence of recurrence. There were no treatment-related deaths, but complications developed in 14 patients (12.7%) after RFA.Conclusions In patients with cirrhosis and HCC, RFA produces effective local control of disease in a significant proportion of patients and can be performed safely with minimal complications.