Percutaneous Radiofrequency Ablation versus Partial Hepatectomy for Multicentric Small Hepatocellular Carcinomas: A Nonrandomized Comparative Study
Percutaneous Radiofrequency Ablation versus Partial Hepatectomy for Multicentric Small Hepatocellular Carcinomas: A Nonrandomized Comparative Study
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DOI：
10.1007/s00268-010-0732-9
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发表时间：
2010-11-01
影响因子：
2.6
通讯作者：
Cheng, Shu-Qun
中科院分区：
文献类型：
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作者：
Guo, Wei-Xing;Zhai, Bo;Cheng, Shu-Qun
本研究的目的是比较经皮射频消融（RFA）与部分肝切除术（PH）治疗多中心小肝细胞癌（HCC）的结果。随着射频消融技术的进步，尚不清楚经皮射频消融的微创方法是否可以在多中心性肝癌患者中获得可比的生存结果，但发病率较低。从2002年1月到2007年12月，159名患有两个或三个肝癌的患者，最大肿瘤直径不超过5厘米，没有大血管侵犯或肝外转移，并接受了PH（n = 73）或该研究纳入了 RFA (n = 86)。两组患者均未出现与手术相关的死亡。 PH 后主要并发症的发生率明显高于 RFA 后（19.2% vs. 8.1%）。 PH 后的住院时间明显长于 RFA 后的住院时间（中位数 = 9 天 vs. 3 天）。 PH组和RFA组的1年、3年和5年总生存率分别为91.8、68.7、44.5%和94.2、64.4、21.2%。两组相应的无病生存率分别为62.1%、33.6%、3.6%和29.4%、2.7%、0%。 PH 组的总生存期和无病生存期明显长于 RFA 组。对于多中心小 HCC 患者，PH 比 RFA 带来更好的生存结果。然而，RFA 具有较低的手术相关发病率和较短的住院时间的优点。
The aim of this study was to compare the results of percutaneous radiofrequency ablation (RFA) with those of partial hepatectomy (PH) in the treatment of multicentric small hepatocellular carcinomas (HCCs). With advances in RFA, it is not known whether the minimally invasive approach with percutaneous RFA could attain comparable survival outcomes but with a lower morbidity in patients with multicentric HCCs.From January 2002 and December 2007, 159 patients who had two or three HCCs, with the largest tumor no more than 5 cm in diameter, had no major vascular invasion or extrahepatic metastases, and were treated with either PH (n = 73) or RFA (n = 86) were included in the study.There was no procedure-related mortality in both groups of patients. Major complications happened significantly more often after PH than after RFA (19.2 vs. 8.1%). The hospital stay was significantly longer after PH than after RFA (median = 9 vs. 3 days). The 1-, 3-, and 5-year overall survival rates for the PH and RFA groups were 91.8, 68.7, 44.5% and 94.2, 64.4, 21.2%, respectively. The corresponding disease-free survival rates for the two groups were 62.1, 33.6, 3.6% and 29.4, 2.7, 0%, respectively. The PH group had significantly longer overall survival and disease-free survival than the RFA group.PH resulted in better survival outcomes than RFA for patients with multicentric small HCCs. However, RFA had the benefits of lower procedure-related morbidity and shorter hospital stay.