Salvage treatment for local recurrence of hepatocellular carcinoma after local ablation therapy
Salvage treatment for local recurrence of hepatocellular carcinoma after local ablation therapy
复制标题
DOI：
10.1111/hepr.12313
复制
发表时间：
2014-12-01
影响因子：
4.2
通讯作者：
Baba, Hideo
中科院分区：
文献类型：
--
作者：
Imai, Katsunori;Beppu, Toru;Baba, Hideo
局部消融治疗（LAT）后肝细胞癌（HCC）的局部复发是一个严重的问题，但是，最佳的治疗策略仍不清楚。MethodsA回顾性分析了50例局部复发的HCC后LAT进行挽救性肝切除术（n=23）或射频消融（RFA; n=27）。他们的背景特征，术中数据，术后的短期和长期outcome.ResultsThe RFA组被发现与受损的肝脏功能储备，较小的数量和大小的肿瘤显着相关。肝切除组手术时间明显延长，术中失血量增加，红细胞输注频率增加。住院期间死亡率和发病率无显著差异。两组无病生存期和总生存期无显著差异。虽然肝切除术后局部复发率为0（0%），RFA为7（25.9%），但这并不影响总生存率。肿瘤大小在以前的LAT被确定为一个独立的预后因素，无病生存和血清白蛋白的总survival. ConclusionWhile挽救性肝切除术局部复发肝癌推荐为选定的患者在其良好的局部控制效果，挽救性RFA也是可以接受的，因为它是侵入性较低，也有一个合理的长期结果。
AimLocal recurrence of hepatocellular carcinoma (HCC) after local ablation therapy (LAT) is a serious problem; however, the optimal treatment strategy remains unclear.MethodsA retrospective analysis was conducted of 50 patients with local recurrence of HCC after LAT that underwent either salvage hepatectomy (n=23) or radiofrequency ablation (RFA; n=27). Their background characteristics, intraoperative data, and postoperative short- and long-term outcome were analyzed.ResultsThe RFA group was found to be significantly associated with an impaired liver functional reserve, smaller number and size of tumors. The hepatectomy group showed a significantly longer operation time, greater intraoperative blood loss and more frequent red blood cell transfusion. In-hospital stay mortality and morbidity rate did not significantly differ. The disease-free and overall survival showed no significant difference between the groups. Although local recurrence after salvage treatment was found in zero (0%) for hepatectomy and in seven (25.9%) for RFA, that did not affect the overall survival. The tumor size at the prior LAT was identified as an independent prognostic factor for disease-free survival and serum albumin for overall survival.ConclusionWhereas salvage hepatectomy for local recurrent HCC is recommended for selected patients in terms of its good local control effect, salvage RFA is also acceptable because it is less invasive and also has a reasonable long-term outcome.