A Randomized Trial Comparing Radiofrequency Ablation and Surgical Resection for HCC Conforming to the Milan Criteria
A Randomized Trial Comparing Radiofrequency Ablation and Surgical Resection for HCC Conforming to the Milan Criteria
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DOI：
10.1097/sla.0b013e3181efc656
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发表时间：
2010-12-01
影响因子：
9
通讯作者：
Zeng, Yong
中科院分区：
文献类型：
--
作者：
Huang, Jiwei;Yan, Lvnan;Zeng, Yong
目的：比较手术切除和射频消融治疗小肝癌（HCC）的长期结局。背景资料：射频消融（RFA）是一种有前途的新兴治疗小肝癌的方法。它是否是有效的手术切除术（RES）的长期outcomes.Methods：230肝癌患者符合米兰标准，适合于治疗RES或RFA进入一个随机对照试验。治疗后定期随访5年（死亡者除外）。主要终点是总生存率;次要终点是无复发生存率、总复发率和早期复发率。RFA组和RES组的1、2、3、4和5年总生存率分别为86.96%、76.52%、69.57%、66.09%、54.78%和98.26%、96.52%，92.17%、82.60%、75.65%。无复发生存率分别为81.74%、59.13%、46.08%、33.91%、28.69%和85.22%、73.92%、60.87%、54.78%、51.30%。RFA组的总生存率和无复发生存率显著低于RES组（P = 0.001和P = 0.017）。RFA组的1、2、3、4和5年总复发率分别为16.52%、38.26%、49.57%、59.13%和63.48%，RES组分别为12.17%、22.60%、33.91%、39.13%和41.74%。RFA组的总复发率高于RES组（P = 0.024）。结论：对于符合米兰标准的HCC患者，手术切除可能提供更好的生存率和更低的复发率。
Objective: To compare the long-term outcomes of surgical resection and radiofrequency ablation for the treatment of small hepatocellular carcinoma (HCC).Summary Background Data: Radiofrequency ablation (RFA) is a promising, emerging therapy for small HCC. Whether it is as effective as surgical resection (RES) for long-term outcomes is still indefinite.Methods: Two hundred thirty HCC patients who met the Milan criteria and were suitable to be treated by either RES or RFA entered into a randomized controlled trial. The patients were regularly followed up after treatment for 5 years (except for those who died). The primary end point was overall survival; the secondary end points were recurrence-free survival, overall recurrence, and early-stage recurrence.Results: The 1-, 2-, 3-, 4- and 5-year overall survival rates for the RFA group and the RES group were 86.96%, 76.52%, 69.57%, 66.09%, 54.78% and 98.26%, 96.52%, 92.17%, 82.60%, 75.65%, respectively. The corresponding recurrence-free survival rates for the 2 groups were 81.74%, 59.13%, 46.08%, 33.91%, 28.69% and 85.22%, 73.92%, 60.87%, 54.78%, 51.30%, respectively. Overall survival and recurrence-free survival were significantly lower in the RFA group than in the RES group (P = 0.001 and P = 0.017). The 1-, 2-, 3-, 4-, and 5-year overall recurrence rates were 16.52%, 38.26%, 49.57%, 59.13%, and 63.48% for the RFA group and 12.17%, 22.60%, 33.91%, 39.13%, and 41.74% for the RES group. The overall recurrence was higher in the RFA group than in the RES group (P = 0.024).Conclusions: Surgical resection may provide better survival and lower recurrence rates than RFA for patients with HCC to the Milan criteria.