Radiofrequency Ablation Versus Surgical Resection for Hepatocellular Carcinoma in Childs A Cirrhotics-a Retrospective Study of 1,061 Cases
Radiofrequency Ablation Versus Surgical Resection for Hepatocellular Carcinoma in Childs A Cirrhotics-a Retrospective Study of 1,061 Cases
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DOI：
10.1007/s11605-010-1372-y
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发表时间：
2011-02-01
影响因子：
3.2
通讯作者：
Zeng, Yong
中科院分区：
文献类型：
--
作者：
Huang, Jiwei;Hernandez-Alejandro, Roberto;Zeng, Yong
射频消融术（RFA）与手术切除术治疗肝细胞癌（HCC）患者的长期结局仍存在争议。1061例原发性肝癌患者被纳入一项回顾性研究。413例接受RFA治疗，648例接受手术切除，比较两组的总体（OS）、无复发（RFS）和无肿瘤生存（TFS），并进行亚组分析。手术切除组的5年OS和相应RFS以及DFS显著高于RFA组（p < 0.001，p < 0.001，p < 0.001）。在孤立性HCC的亚组分析中，每千个货币符号3 cm的部分，两组之间的RFS没有显著差异（p = 0.719）。尽管如此，在该亚组中，手术切除术的OS和TFS优于RFA，在3 cm < HCC < 5 cm的孤立性病变和多灶性HCC的亚组分析中，手术切除术的OS、RFS和TFS也优于RFA。血清AFP是所有生存分析的唯一显著预测因素。当治疗查尔兹A型肝细胞癌大于3 cm但小于5 cm的孤立性肝癌或两个或三个病灶均小于5 cm时，手术切除比RFA提供更好的生存率。当治疗患有孤立性HCC的查尔兹A患者时，RFA的RFS与手术切除相当，但RFA的侵入性较小。
The long-term outcomes of radiofrequency ablation (RFA) vs. surgical resection in cirrhotic patients with hepatocellular carcinoma (HCC) remain controversial. One thousand sixty-one cirrhotic HCC patients were included into a retrospective study. Four hundred thirteen received RFA and 648 received surgical resection.Overall (OS), recurrence-free (RFS), and tumor-free survival (TFS) were compared between the two groups and in subgroup analyses. The 5-year OS and corresponding RFS as well as DFS were significantly higher in the surgical resection group compared with the RFA group (p < 0.001, p < 0.001, p < 0.001). In subgroup analyses of solitary HCC a parts per thousand currency sign3 cm, there was no significant difference in RFS between the two groups (p = 0.719). Nonetheless, surgical resection was superior to RFA for OS and TFS in this subgroup as well as for OS, RFS, and TFS in subgroup analyses for solitary lesions 3 cm < HCC < 5 cm and multifocal HCC. Serum AFP was the only significant predicting factor for all survival analyses.When treating Childs A cirrhotic patients with solitary HCC larger than 3 cm but less than 5 cm, or with two or three lesions each less than 5 cm, surgical resection provides a better survival than RFA. When treating Childs A cirrhotics with solitary HCC a parts per thousand currency signaEuro parts per thousand 3 cm, RFA has a comparable RFS to surgical resection, but RFA is less invasive.