Radiofrequency Ablation for Hepatocellular Carcinoma: Updated Review in 2010
Radiofrequency Ablation for Hepatocellular Carcinoma: Updated Review in 2010
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DOI：
10.1159/000315239
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发表时间：
2010-01-01
期刊：
影响因子：
3.5
通讯作者：
Kudo, Masatoshi
中科院分区：
文献类型：
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作者：
Kudo, Masatoshi
经皮射频消融术（RFA）治疗肝细胞癌（HCC）于1999年在日本被引入。它已成为包括日本在内的世界各地主要的局部治疗方法。在比较切除和RFA之间的结果时，在许多报道中，当病例限于3个或更少的肿瘤（3cm或更小）时，它们是可比性的，基于此，RFA已成为小型hcc的主要治疗方法。在日本肝癌研究组登记的患者中，RFA后的5年生存率高达57%，当病例仅限于肝损伤A （Child-Pugh A）时为73%，而肝损伤A （Child-Pugh A）中单个2-cm或更小的肝肿瘤和2- 5-cm肝肿瘤分别为83.8%和76.3%，其结果与切除相当。我们的结果也很好：Child-Pugh A肝功能HCC患者在RFA和切除后，肿瘤小于或等于3厘米的5年生存率分别为84%和78%。以前曾报道过射频消融术的各种并发症和局限性，但医生技术的进步和各种技术的发展减少了并发症并扩大了射频消融术的适应症。tace联合、人工胸腔积液和腹水联合、超声造影引导下的射频消融术都是很好的例子。治疗后的辅助治疗，如干扰素和分子靶向治疗，有望进一步提高RFA后的生存率。版权所有：S. Karger AG，巴塞尔
Percutaneous radiofrequency ablation (RFA) for hepatocellular carcinoma (HCC) was introduced in Japan in 1999. It has been established as a main local treatment method worldwide including Japan. On comparing outcomes between resection and RFA, they were comparable when cases were limited to those with 3 or fewer tumors 3 cm or smaller in many reports, based on which RFA has become the main treatment for small HCCs. The 5-year survival rate following RFA was as high as 57% in patients registered in the Liver Cancer Study Group of Japan, 73% when cases were limited to liver damage A (Child-Pugh A), and 83.8 and 76.3% in liver damage A (Child-Pugh A) cases with a single 2-cm or smaller and 2- to 5-cm liver tumor, respectively, showing outcomes equivalent to those of resection. The outcomes at our facility were also favorable: the 5-year survival rates of Child-Pugh A liver function HCC cases with 3 or fewer tumors 3 cm or smaller following RFA and resection were 84 and 78%, respectively. Various complications and limitations of RFA have previously been reported, but the advances of physicians' skills and development of various techniques have reduced complications and expanded the indications for RAF. TACE-combined, artificial pleural effusion-and ascites-combined, and contrast-enhanced ultrasonography-guided RFAs are good examples. Adjuvant therapy, such as interferon and molecular targeted therapies following curative therapy, is expected to further improve survival after RFA. Copyright (C) 2010 S. Karger AG, Basel