Radiofrequency ablation improves prognosis compared with ethanol injection for hepatocellular carcinoma ≤4cm
Radiofrequency ablation improves prognosis compared with ethanol injection for hepatocellular carcinoma ≤4cm
复制标题
DOI：
10.1053/j.gastro.2004.09.003
复制
发表时间：
2004-12-01
期刊：
影响因子：
29.4
通讯作者：
Chen, YC
中科院分区：
文献类型：
--
作者：
Lin, SM;Lin, CJ;Chen, YC
背景和目标：本研究的目的是比较经皮射频（RF）消融、常规经皮无水乙醇注射（PEI）和高剂量PEI治疗4 cm或以下肝细胞癌（HCC）的临床结局。方法：共157例患者，186个4cm或更小的HCC，随机分为3组（常规PEI组52例，高剂量PEI组53例，RF组52例）。比较了3组的临床结局，包括肿瘤完全坏死、总生存期、局部肿瘤进展、额外新发肿瘤和无癌生存期。结果：常规PEI组肿瘤完全坏死率为88%，高剂量PEI组为92%，RF组为96%。RF组实现肿瘤完全坏死所需的时间明显少于其他两组（P <0.01）。RF组的局部肿瘤进展率最低（与常规PEI组相比，P = 0.012;与高剂量PEI组相比，P = 0.037）。RF组的总生存率最高（与常规PEI组相比，P = 0.014;与高剂量PEI组相比，P = 0.023）。RF组的无癌生存率最高（与常规PEI组相比，P = 0.019;与高剂量PEI组相比，P = 0.024）。多变量分析确定肿瘤大小、肿瘤分化和治疗方法（RF vs PEI的两种方法）是与局部肿瘤进展、总生存期和无癌生存期相关的重要因素。结论：结果表明，射频消融治疗直径小于等于4 cm的HCC的临床结局优于常规和高剂量PEI。
Background & Aims: The aim of this study was to compare the clinical outcome of percutaneous radiofrequency (RF) ablation, conventional percutaneous ethanol injection (PEI), and higher-dose PEI in treating hepatocellular carcinoma (HCC) 4 cm or less. Methods: A total of 157 patients with 186 HCCs 4 cm or less were randomly assigned to 3 groups (52 patients in the conventional PEI group, 53 in the higher-dose PEI group, and 52 in the RF group). Clinical outcomes in terms of complete tumor necrosis, overall survival, local tumor progression, additional new tumors, and cancer-free survival were compared across 3 groups. Results: The rate of complete tumor necrosis was 88% in the conventional PEI group, 92% in the higher-dose PEI group, and 96% in the RF group. Significantly fewer sessions were required to achieve complete tumor necrosis in the RF group than in the other 2 groups (P < .01). The local tumor progression rate was lowest in the RF group (vs the conventional PEI group, P = .012; vs the higher-dose PEI group, P = .037). The overall survival rate was highest in the RF group (vs the conventional PEI group, P = .014; vs the higher-dose PEI group, P = .023). The cancer-free survival rate was highest in the RF group (vs the conventional PEI group, P = .019; vs. the higher-dose PEI group, P = .024). Multivariate analysis determined that tumor size, tumor differentiation, and the method of treatment (RF vs both methods of PEI) were significant factors in relation to local tumor progression, overall survival, and cancer-free survival. Conclusions: The results show that RF ablation yielded better clinical outcomes than conventional and higher-dose PEI in treating HCC 4 cm or less.