中华消化外科杂志
中華消化外科雜誌
중화소화외과잡지
CHINESE JOURNAL OF DIGESTIVE SURGERY
2011年
1期
36-39
,共4页
梁惠宏%彭振维%陈敏山%邵子力%彭和平%张耀军%张亚奇%李锦清
樑惠宏%彭振維%陳敏山%邵子力%彭和平%張耀軍%張亞奇%李錦清
량혜굉%팽진유%진민산%소자력%팽화평%장요군%장아기%리금청
肝细胞癌%复发%导管消融,射频%肝切除术%疗效分析
肝細胞癌%複髮%導管消融,射頻%肝切除術%療效分析
간세포암%복발%도관소융,사빈%간절제술%료효분석
Hepatocellular carcinoma%Recurrence%Catheter ablation,radiofrequency%Hepatectomy%Efficacy analysis
目的 比较经皮射频消融(PRFA)与再手术切除治疗单个直径≤3 cm的复发性肝癌的疗效.方法 回顾性分析1999年1月至2009年12月中山大学肿瘤防治中心收治的151例复发性肝癌(单个肿瘤直径≤3 cm)患者的临床资料,其中79例患者行PRFA(PRFA组),72例行肿瘤再手术切除(再手术切除组).比较两组患者的生存率、并发症发生率及肿瘤复发情况.计量资料比较采用t检验,计数资料比较采用x2检验,生存率计算采用寿命表法,生存曲线采用Kaplan-Meier法绘制,组间比较采用Log-rank检验.结果 PRFA组和再手术切除组并发症发生率分别为13%(10/79)和36%(26/72),两组比较,差异有统计学意义(x2=11.411,P＜0.05).PRFA组和再手术切除组1～5年累积生存率分别为89.7%、75.2%、67.1%、61.5%、56.6%和86.0%、67.6%、53.6%、44.1%、40.2%,两组总体生存曲线比较,差异无统计学意义(x2=1.610,P＞0.05).PRFA组4、5年累积生存率显著高于再手术切除组(x2=4.682,4.196,P＜0.05).PRFA组肿瘤局部复发率为5%(4/79),再手术切除组切缘复发率为3%(2/72),两组比较,差异无统计学意义(x2=0.565,P＞0.05).结论 PRFA治疗单个直径≤3 cm的复发性肝癌的长期疗效优于再手术切除,且具有微创的优势.
目的 比較經皮射頻消融(PRFA)與再手術切除治療單箇直徑≤3 cm的複髮性肝癌的療效.方法 迴顧性分析1999年1月至2009年12月中山大學腫瘤防治中心收治的151例複髮性肝癌(單箇腫瘤直徑≤3 cm)患者的臨床資料,其中79例患者行PRFA(PRFA組),72例行腫瘤再手術切除(再手術切除組).比較兩組患者的生存率、併髮癥髮生率及腫瘤複髮情況.計量資料比較採用t檢驗,計數資料比較採用x2檢驗,生存率計算採用壽命錶法,生存麯線採用Kaplan-Meier法繪製,組間比較採用Log-rank檢驗.結果 PRFA組和再手術切除組併髮癥髮生率分彆為13%(10/79)和36%(26/72),兩組比較,差異有統計學意義(x2=11.411,P＜0.05).PRFA組和再手術切除組1～5年纍積生存率分彆為89.7%、75.2%、67.1%、61.5%、56.6%和86.0%、67.6%、53.6%、44.1%、40.2%,兩組總體生存麯線比較,差異無統計學意義(x2=1.610,P＞0.05).PRFA組4、5年纍積生存率顯著高于再手術切除組(x2=4.682,4.196,P＜0.05).PRFA組腫瘤跼部複髮率為5%(4/79),再手術切除組切緣複髮率為3%(2/72),兩組比較,差異無統計學意義(x2=0.565,P＞0.05).結論 PRFA治療單箇直徑≤3 cm的複髮性肝癌的長期療效優于再手術切除,且具有微創的優勢.
목적 비교경피사빈소융(PRFA)여재수술절제치료단개직경≤3 cm적복발성간암적료효.방법 회고성분석1999년1월지2009년12월중산대학종류방치중심수치적151례복발성간암(단개종류직경≤3 cm)환자적림상자료,기중79례환자행PRFA(PRFA조),72례행종류재수술절제(재수술절제조).비교량조환자적생존솔、병발증발생솔급종류복발정황.계량자료비교채용t검험,계수자료비교채용x2검험,생존솔계산채용수명표법,생존곡선채용Kaplan-Meier법회제,조간비교채용Log-rank검험.결과 PRFA조화재수술절제조병발증발생솔분별위13%(10/79)화36%(26/72),량조비교,차이유통계학의의(x2=11.411,P＜0.05).PRFA조화재수술절제조1～5년루적생존솔분별위89.7%、75.2%、67.1%、61.5%、56.6%화86.0%、67.6%、53.6%、44.1%、40.2%,량조총체생존곡선비교,차이무통계학의의(x2=1.610,P＞0.05).PRFA조4、5년루적생존솔현저고우재수술절제조(x2=4.682,4.196,P＜0.05).PRFA조종류국부복발솔위5%(4/79),재수술절제조절연복발솔위3%(2/72),량조비교,차이무통계학의의(x2=0.565,P＞0.05).결론 PRFA치료단개직경≤3 cm적복발성간암적장기료효우우재수술절제,차구유미창적우세.
Objective To compare the efficacy of percutaneous radiofrequency ablation (PRFA) and repeat hepatectomy for solitary recurrent hepatocellular carcinoma (HCC) with the diameter≤3 cm. Methods The clinical data of 151 patients with recurrent HCC (diameter≤3 cm) who were admitted to the Cancer Center of Sun Yat-Sen University from January 1999 to December 2009 were retrospectively analyzed. Of all the patients, 79received PRFA (PRFA group) and 72 received repeat hepatectomy (repeat hepatectomy group). The survival rate, morbidity and recurrence of the tumor between the two groups were compared. All data were analyzed using t test, chi-square test or Log-rank test, and the survival of the patients were analyzed using the Kaplan-Meier method. Results The mobidities of the PRFA group and repeat hepatectomy group were 13% (10/79) and 36%(26/72), respectively, with a significant difference between the two groups (x2=11.411, P＜0.05). The cumulative 1-, 2-, 3-, 4-, 5-year survival rates were 89.7%, 75.2%, 67.1%, 61.5%, 56.6% in the PRFA group, and 86.0%, 67.6%, 53.6%, 44.1%, 40.2% in the repeat hepatectomy group, with no significant difference between the two groups (x2=1.610, P＞0.05). The cumulative 4-, 5-year survival rates of the PRFA group were significant higher than those in the repeat hepatectomy group (x2=4.682, 4. 196, P ＜ 0.05). The local tumor recurrence rate of the PRFA group was 5% (4/79), and the incisal margin recurrence rate was 3% (2/72) in the repeat hepatectomy group, with no significant difference between the two groups (x2=0.565, P＞0.05). Conclusion As a less invasive treatment method, PRFA is superior to repeat hepatectomy for solitary recurrent HCC with the diameter≤3 cm.
