CAJ | 학술논문

目的探讨肝细胞癌(HCC)射频消融(RFA)治疗后肿瘤残留的危险因素及预后.方法回顾性分析2001年5月至2007年3月114例经RFA治疗的HCC患者临床资料,分析可能与RFA后肿瘤残留有关的临床因素以及残留HCC的预后.结果 114例HCC患者经RFA治疗一次后,完全消融90例,肿瘤残留24例.90例肿瘤完全消融患者的中位生存期为40个月,24例肿瘤残留患者的中位生存期为29个月,二者差异无统计学意义(P=0.242).在24例肿瘤残留患者中,经再次治疗后达到无肿瘤残留者11例,其中位生存期为53个月;经再次治疗后仍有残留者13例,其中位生存期为28个月.RFA治疗一次后肿瘤完全消融患者与再次治疗后达到无肿瘤残留患者的中位生存期比较,差异无统计学意义(P=0.658);与再次治疗后仍有肿瘤残留患者的中位生存期比较,差异有统计学意义(P=0.012).多因素分析表明,肿瘤＞3 cm(P=0.007)和靠近大血管(P=0.042)是HCC经RFA治疗后肿瘤残留的独立危险因素.结论肿瘤＞3 cm和靠近大血管是HCC行RFA治疗后肿瘤残留的独立危险因素.对未能达到完全消融的HCC患者,应积极采取进一步治疗措施,争取达到完全根治肿瘤,以改善预后.
목적 탐토간세포암(HCC)사빈소융(RFA)치료후종류잔류적위험인소급예후.방법 회고성분석2001년5월지2007년3월114례경RFA치료적HCC환자림상자료,분석가능여RFA후종류잔류유관적림상인소이급잔류HCC적예후.결과 114례HCC환자경RFA치료일차후,완전소융90례,종류잔류24례.90례종류완전소융환자적중위생존기위40개월,24례종류잔류환자적중위생존기위29개월,이자차이무통계학의의(P=0.242).재24례종류잔류환자중,경재차치료후체도무종류잔류자11례,기중위생존기위53개월;경재차치료후잉유잔류자13례,기중위생존기위28개월.RFA치료일차후종류완전소융환자여재차치료후체도무종류잔류환자적중위생존기비교,차이무통계학의의(P=0.658);여재차치료후잉유종류잔류환자적중위생존기비교,차이유통계학의의(P=0.012).다인소분석표명,종류＞3 cm(P=0.007)화고근대혈관(P=0.042)시HCC경RFA치료후종류잔류적독립위험인소.결론 종류＞3 cm화고근대혈관시HCC행RFA치료후종류잔류적독립위험인소.대미능체도완전소융적HCC환자,응적겁채취진일보치료조시,쟁취체도완전근치종류,이개선예후.
Objective To investigate the risk factors and prognosis of patients with residual tumor after radiofrequency ablation(UFA)for hepatoceUular carcinoma(HCC).Methods The clinicopathological data of 114 patients with HCC undergoing RFA in our hospital from May 2000 to March 2007 were retrospectively studied,and the prognostic factors of residual tumor were analyzed.Results After one session of RFA,90 patients had complete ablation and 24 had residual tumor.The median overall survivals in the complete ablation group and residual tumor group were 40 and 29 months,respectively.There was no statistically significant difference between those two groups(P=0.242).24 patients with residual tumor were re-treated by RFA or hepatectomy or TACE.Among them 11 patients achieved complete response and 13 incomplete response,their median overall survival were 53 and 28 months,respectively.There was no significant difference between first complete ablation group and second complete response group(P=0.658).However,compared with the first complete ablation group,the incomplete response group had poor prognosis(P=0.012).Multivariate analysis showed that tumor size＞3 cm(P=0.007)and proximity to a large vessel(P=0.042)were independent risk factors for residual tumor after RFA.Conclusion Tumor size＞3 cm and proximity to a large vessel are independent risk factors for residual tumor after RFA.Further treatment of residual tumor is necessary to eliminate the tumor and improve prognosis.