Repeated Hepatic Resection versus Radiofrequency Ablation for Recurrent Hepatocellular Carcinoma after Hepatic Resection: A Propensity Score Matching Study
Repeated Hepatic Resection versus Radiofrequency Ablation for Recurrent Hepatocellular Carcinoma after Hepatic Resection: A Propensity Score Matching Study
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DOI：
10.1148/radiol.14141568
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发表时间：
2015-05-01
期刊：
影响因子：
19.7
通讯作者：
Joh, Jae-Won
中科院分区：
文献类型：
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作者：
Song, Kyoung Doo;Lim, Hyo Keun;Joh, Jae-Won
目的：比较反复肝切除和射频消融治疗复发性肝细胞癌的远期疗效。材料和方法：这项回顾性研究获得了机构评审委员会的批准，免除了知情同意的要求。在1994年11月至2012年12月期间，因复发的肝细胞癌(平均肿瘤大小+/-标准差，1.8 cm+/-0.7)而接受射频消融的患者中，39例再次接受了肝切除，178例接受了射频消融。患者年龄从24岁到85岁不等，平均54.9岁。男性的年龄从25岁到85岁(平均54.8岁)，女性的年龄从24岁到76岁(平均55.4岁)。再次肝切除组与射频消融组采用1：2配对，采用倾向性评分匹配法。比较配对前后患者的总生存期(OS)和无病生存期(DFS)。结果：配对前1、3、5、8年OS率分别为88.8%、88.8%、83.9%和56.3%，射频消融组分别为98.9%、82.5%、71.0%和58.3%。再手术组1、3、5年DFS分别为66.1%、48.5%、43.1%，射频消融组分别为70.1%、40.8%、30.0%。射频消融组(n=78)术后1、3、5、8年OS率分别为98.7%、85.7%、72.1%、68.6%，DFS率分别为71.8%、45.1%、39.4%。配对前(P=.686，P=.461)和配对后(P=.834，P=.960)两组患者的OS率和DFS率均无显著差异。再次肝切除组术后死亡率为2.6%，射频消融组为0。结论：肝切除术后复发肝癌患者的远期OS和DFS与射频消融组无显著差异。(C)RSNA，2015年
Purpose: To compare the long-term outcomes of repeated hepatic resection and radiofrequency (RF) ablation for recurrent hepatocellular carcinoma (HCC) by using propensity score matching.Materials and Methods: This retrospective study was approved by the institutional review board, and the requirement to obtain informed consent was waived. Thirty-nine patients who underwent repeated hepatic resection and 178 who underwent RF ablation for recurrent HCC (mean tumor size +/- standard deviation, 1.8 cm +/- 0.7) between November 1994 and December 2012 were included in the study. Patients ranged in age from 24 to 85 years (mean, 54.9 years). Men ranged in age from 25 to 85 years (mean, 54.8 years), and women ranged in age from 24 to 76 years (mean, 55.4 years). A 1: 2 repeated hepatic resection group-RF ablation group matching was done by using propensity score matching. The overall survival (OS) and disease-free survival (DFS) were compared before and after propensity score matching. Complications were assessed.Results: Before matching, OS rates at 1, 3, 5, and 8 years were 88.8%, 88.8%, 83.9%, and 56.3%, respectively, with repeated hepatic resection and 98.9%, 82.5%, 71.0%, and 58.3% for RF ablation. DFS rates at 1, 3, and 5 years were 66.1%, 48.5%, and 43.1% for repeated hepatic resection and 70.1%, 40.8%, and 30.0% for RF ablation. After matching, the OS rates at 1, 3, 5, and 8 years were 98.7%, 85.7%, 72.1%, and 68.6%, respectively, and the DFS rates at 1, 3, and 5 years were 71.8%, 45.1%, and 39.4% in the RF ablation group (n = 78). Neither the OS nor DFS rate was significantly different between the two groups before matching (P = .686 and P = .461) and after matching (P =.834 and P = .960). The postoperative mortality rate was 2.6% in the repeated hepatic resection group and 0% in the RF ablation group.Conclusion: The long-term OS and DFS were not significantly different between repeated hepatic resection and RF ablation for patients with recurrent HCC after hepatic resection. (C) RSNA, 2015