中华外科杂志
中華外科雜誌
중화외과잡지
CHINESE JOURNAL OF SURGERY
2008年
21期
1617-1620
,共4页
徐立%黎鹏%陈敏山%庞雄昊%高恒军%彭振维%梁惠宏%张耀军%李锦清
徐立%黎鵬%陳敏山%龐雄昊%高恆軍%彭振維%樑惠宏%張耀軍%李錦清
서립%려붕%진민산%방웅호%고항군%팽진유%량혜굉%장요군%리금청
肝肿瘤%导管消融术%复发%治疗结果
肝腫瘤%導管消融術%複髮%治療結果
간종류%도관소융술%복발%치료결과
Liver neoplasms%Catheter ablation%Recurrent%Treatment outcome
目的 评价以射频消融为主的微创方式治疗肝细胞癌切除术后复发的疗效及安全性.方法 回顾性分析1999年8月至2008年2月间接受以经皮射频消融为主的微创方式治疗的84例肝癌切除术后复发患者的临床资料.结果 未见治疗相关性死亡,严重并发症发生率为2.4%(2/84),完全消融率为94.0%(79/84),治疗后1、3、5年总生存率分别为74.9%、54.%、48.2%.肿瘤最大径≤3 cm和>3 cm的患者治疗后1、3、5年总生存率分别为83.2%、67.7%、67.7%和59.1%、24.2%、12.1%(P=0.003),术后复发间隔时间≤1年和>1年的患者治疗后1、3、5年总生存率分别为72.1%、36.2%、24.2%和76.8%、70.6%、65.1%(P=0.040).结合和未结合瘤内无水酒精注射的患者术后1、3、5年总生存率分别为76.5%、57.3%、57.3%和66.7%、33.3%、22.2%(P=0.017);结合和未结合经导管肝动脉栓塞化疗的患者治疗后1、3、5年总生存率分别为81.6%、66.0%、57.5%和55.6%、24.7%、24.7%(P=0.001).结论 射频消融是治疗肝癌切除术后复发安全、有效的手段,肿瘤大小和复发间隔是其疗效的重要影响因素.联合瘤内无水酒精注射或肝动脉栓塞化疗有助于提高射频消融对复发性肝癌的疗效.
目的 評價以射頻消融為主的微創方式治療肝細胞癌切除術後複髮的療效及安全性.方法 迴顧性分析1999年8月至2008年2月間接受以經皮射頻消融為主的微創方式治療的84例肝癌切除術後複髮患者的臨床資料.結果 未見治療相關性死亡,嚴重併髮癥髮生率為2.4%(2/84),完全消融率為94.0%(79/84),治療後1、3、5年總生存率分彆為74.9%、54.%、48.2%.腫瘤最大徑≤3 cm和>3 cm的患者治療後1、3、5年總生存率分彆為83.2%、67.7%、67.7%和59.1%、24.2%、12.1%(P=0.003),術後複髮間隔時間≤1年和>1年的患者治療後1、3、5年總生存率分彆為72.1%、36.2%、24.2%和76.8%、70.6%、65.1%(P=0.040).結閤和未結閤瘤內無水酒精註射的患者術後1、3、5年總生存率分彆為76.5%、57.3%、57.3%和66.7%、33.3%、22.2%(P=0.017);結閤和未結閤經導管肝動脈栓塞化療的患者治療後1、3、5年總生存率分彆為81.6%、66.0%、57.5%和55.6%、24.7%、24.7%(P=0.001).結論 射頻消融是治療肝癌切除術後複髮安全、有效的手段,腫瘤大小和複髮間隔是其療效的重要影響因素.聯閤瘤內無水酒精註射或肝動脈栓塞化療有助于提高射頻消融對複髮性肝癌的療效.
목적 평개이사빈소융위주적미창방식치료간세포암절제술후복발적료효급안전성.방법 회고성분석1999년8월지2008년2월간접수이경피사빈소융위주적미창방식치료적84례간암절제술후복발환자적림상자료.결과 미견치료상관성사망,엄중병발증발생솔위2.4%(2/84),완전소융솔위94.0%(79/84),치료후1、3、5년총생존솔분별위74.9%、54.%、48.2%.종류최대경≤3 cm화>3 cm적환자치료후1、3、5년총생존솔분별위83.2%、67.7%、67.7%화59.1%、24.2%、12.1%(P=0.003),술후복발간격시간≤1년화>1년적환자치료후1、3、5년총생존솔분별위72.1%、36.2%、24.2%화76.8%、70.6%、65.1%(P=0.040).결합화미결합류내무수주정주사적환자술후1、3、5년총생존솔분별위76.5%、57.3%、57.3%화66.7%、33.3%、22.2%(P=0.017);결합화미결합경도관간동맥전새화료적환자치료후1、3、5년총생존솔분별위81.6%、66.0%、57.5%화55.6%、24.7%、24.7%(P=0.001).결론 사빈소융시치료간암절제술후복발안전、유효적수단,종류대소화복발간격시기료효적중요영향인소.연합류내무수주정주사혹간동맥전새화료유조우제고사빈소융대복발성간암적료효.
Objective To evaluate the efficacy and safety of pereutaneous radiofrequency ablation (PRFA) and combined with other minimally invasive treatments for recurrent hepatocellular carcinoma (RHCC) after hepatectomy. Methods Eighty-four patients with RHCC after hepatectomy who were treated with PRFA or combined with other minimally invasive therapies between August 1999 and February 2008 were analyzed retrospectively. Results There was no treatment related mortality in the study population, and the morbidity was 2.4% (2/84). The complete ablation rate was 94.0% (79/84),and the 1-,3- and 5-year overall survival rates were 74.9% ,54.9% and 48.2%, respectively. The 1-,3- and 5-year overall survival rates of patients with recurrent interval after hepatectomy less than 1 year and over 1 year were 72.1%,36.2%,24.2% and 76.8% ,70.6% and 65.1%,respectively (P=0.040). The 1-,3- and 5-year overall survival rates of patients with tumor size ≤ 3 cm and > 3 cm were 83.2% ,67.7% ,67.7% and 59.1%,24.2%, 12.1%,respectively (P=0.003). The 1-, 3- and 5-year overall survival rates of patients treated with PRFA alone and combined with percutaneous ethanol injection (PEI) were 66.7%, 33.3%, 22.2% and 76.5% ,57.3% ,57.3%, respectively (P=0.017). The 1-, 3- and 5-year overall survival rates of patients treated with PRFA alone and combined with transcatheter hepatic arterial chemoembolization (TACE) were 55.6%, 24.7%, 24.7% and 81.6%, 66.0%, 57.5%, respectively (P=0.001).Conclusions PRFA is an effective and safe treatment for RHCC,and tumor size and recurrent interval afterhepatectomy are important prognostic factors. Combination with PEI or TACE may improve the efficacy of PRFA for treatment of RHCC.
