中华外科杂志
中華外科雜誌
중화외과잡지
CHINESE JOURNAL OF SURGERY
2008年
21期
1614-1616
,共3页
任正刚%干育红%樊嘉%陈漪%吴志全%钦伦秀%葛宁灵%周俭%夏景林%王艳红%叶青海%王鲁%叶胜龙
任正剛%榦育紅%樊嘉%陳漪%吳誌全%欽倫秀%葛寧靈%週儉%夏景林%王豔紅%葉青海%王魯%葉勝龍
임정강%간육홍%번가%진의%오지전%흠륜수%갈저령%주검%하경림%왕염홍%협청해%왕로%협성룡
肝肿瘤%复发%治疗%射频毁损术
肝腫瘤%複髮%治療%射頻燬損術
간종류%복발%치료%사빈훼손술
Hepatocellular neoplasms%Recurrence%Therapy%Radiofrequency ablation
目的 研究射频毁损术治疗肝癌切除术后疗效以及其与再手术切除效果的比较.方法 病例为2000年1月至2005年12月间在复旦大学肝癌研究所治疗的213例复发性小肝癌(肿瘤结节直径≤3 cm,结节数≤3个),包括射频毁损术68例,再手术切除145例.Kaplan-Meier方法估计生存期,Log-rank分析生存曲线之间的差别,COX比例风险模型多因素分析影响预后的因素.总体生存率和无瘤生存率从接受射频毁损术或再手术切除治疗时计算.结果 射频毁损术治疗的患者和再手术切除治疗的患者的1、3、5年总生存率分别为94.7%、65.1%、37.3%和88.1%、62.6%、41.0%,其生存曲线无明显差别(P=0.693).但射频毁损术的1、3、5年无瘤生存率低于再手术切除组,分别为58.0%、27.8%、12.4%和79.4%、48.1%、34.4%(P=0.001).首次肝癌切除术后复发问期超过2年的患者的预后较好.结论 虽然射频毁损治疗的无瘤生存率低于再手术切除,但其远期总体生存率类似于再手术切除,可作为复发性小肝癌再切除术的替代性治疗.
目的 研究射頻燬損術治療肝癌切除術後療效以及其與再手術切除效果的比較.方法 病例為2000年1月至2005年12月間在複旦大學肝癌研究所治療的213例複髮性小肝癌(腫瘤結節直徑≤3 cm,結節數≤3箇),包括射頻燬損術68例,再手術切除145例.Kaplan-Meier方法估計生存期,Log-rank分析生存麯線之間的差彆,COX比例風險模型多因素分析影響預後的因素.總體生存率和無瘤生存率從接受射頻燬損術或再手術切除治療時計算.結果 射頻燬損術治療的患者和再手術切除治療的患者的1、3、5年總生存率分彆為94.7%、65.1%、37.3%和88.1%、62.6%、41.0%,其生存麯線無明顯差彆(P=0.693).但射頻燬損術的1、3、5年無瘤生存率低于再手術切除組,分彆為58.0%、27.8%、12.4%和79.4%、48.1%、34.4%(P=0.001).首次肝癌切除術後複髮問期超過2年的患者的預後較好.結論 雖然射頻燬損治療的無瘤生存率低于再手術切除,但其遠期總體生存率類似于再手術切除,可作為複髮性小肝癌再切除術的替代性治療.
목적 연구사빈훼손술치료간암절제술후료효이급기여재수술절제효과적비교.방법 병례위2000년1월지2005년12월간재복단대학간암연구소치료적213례복발성소간암(종류결절직경≤3 cm,결절수≤3개),포괄사빈훼손술68례,재수술절제145례.Kaplan-Meier방법고계생존기,Log-rank분석생존곡선지간적차별,COX비례풍험모형다인소분석영향예후적인소.총체생존솔화무류생존솔종접수사빈훼손술혹재수술절제치료시계산.결과 사빈훼손술치료적환자화재수술절제치료적환자적1、3、5년총생존솔분별위94.7%、65.1%、37.3%화88.1%、62.6%、41.0%,기생존곡선무명현차별(P=0.693).단사빈훼손술적1、3、5년무류생존솔저우재수술절제조,분별위58.0%、27.8%、12.4%화79.4%、48.1%、34.4%(P=0.001).수차간암절제술후복발문기초과2년적환자적예후교호.결론 수연사빈훼손치료적무류생존솔저우재수술절제,단기원기총체생존솔유사우재수술절제,가작위복발성소간암재절제술적체대성치료.
Objective To evaluate the efficacy of radiofrequeney ablation for the treatment of postoperative recurrence of hepatocellular carcinoma and whether radiofrequeney ablation can be used as first line treatment for recurrent hepatoeellular carcinoma. Methods There were 213 patients with small recurrent hepatocellular carcinoma (tumor size of 3 em or less and no more than 3 nodules) who treated in Liver Cancer Institute, Fudan University from January 2000 to December 2005. Among these patients 68 were treated with radiofrequency ablation and 145 were treated with repeated surgical resection. Kaplan-Meier method was used to evaluate the overall survival or disease free survival. Log-rank used to determine the survival difference between groups and COX proportional hazard was used for multivariate analysis to evaluate the risk factors for prognosis. The overall survival or disease free survival was calculated from the time treated with radiofrequency or repeated surgical resection. Results The 1-, 3-, 5-years overall survival rates were 94.7%,65.1%, 37.3% and 88.1%,62.6%,41.0% in radiofrequeney ablation group and surgical repeated resection group, respectively. There was no significant difference between two groups (P=0.693).However, the disease free survival was better in repeated surgical resection than in radiofrequeney ablation,which were 79.4%, 48.1%, 34.4% and 58.0%, 27.8%, 12.4% in repeated surgical resection and radiofrequeney ablation,respectively (P=0.001). The interval between recurrence and initial hepatectomy with more than 2 years was independent factor favor to good prognosis. Conclusions Radiofrequency ablation seems to be as effective as repeated surgical resection owing to comparable overall survival and can be ceousidered as alternative therapy for surgical resection treatment of small recurrent hepatocellular carcinoma.
