CAJ | 학술논문

目的探讨CT引导下原发性肝癌腹膜后转移性淋巴结射频消融治疗的临床价值.方法收集2004年3月至2010年7月中山大学附属肿瘤医院医学影像与介入中心32例原发性肝癌并腹膜后淋巴结转移的患者.根据治疗方式将分为两组:A组19例,在CT引导下行腹膜后转移性淋巴结射频消融治疗(肝/肺单发转移灶行射频消融治疗)；B组13例,仅行肝/肺单发转移灶的射频消融而未行淋巴结治疗.采用增强CT或PET/CT对两组患者进行随访,评价A组疗效并对两组患者进行Kaplan-Meier生存分析.结果 A组患者3、6、10、15个月的局部控制率分别为78.9％、73.3％、41.7％、25.0％.Kaplan-Meier生存分析显示A组的1年生存率为26.3％,明显高于B组的7.7％(P =0.029).A组患者未发生胃肠道或胆道热损伤等并发症.结论射频消融是治疗肝癌腹膜后转移性淋巴结安全、有效的微创治疗手段.
목적 탐토CT인도하원발성간암복막후전이성림파결사빈소융치료적림상개치.방법 수집2004년3월지2010년7월중산대학부속종류의원의학영상여개입중심32례원발성간암병복막후림파결전이적환자.근거치료방식장분위량조:A조19례,재CT인도하행복막후전이성림파결사빈소융치료(간/폐단발전이조행사빈소융치료)；B조13례,부행간/폐단발전이조적사빈소융이미행림파결치료.채용증강CT혹PET/CT대량조환자진행수방,평개A조료효병대량조환자진행Kaplan-Meier생존분석.결과 A조환자3、6、10、15개월적국부공제솔분별위78.9％、73.3％、41.7％、25.0％.Kaplan-Meier생존분석현시A조적1년생존솔위26.3％,명현고우B조적7.7％(P =0.029).A조환자미발생위장도혹담도열손상등병발증.결론 사빈소융시치료간암복막후전이성림파결안전、유효적미창치료수단.
Objective To evaluate the clinical value of radiofrequency ablation with retroperitoneal metastatic lymph nodes from primary hepatic carcinoma (PHC).Methods Thirty-two patients with retroperitoneal metastatic lymph node recurrence from PHC were enrolled in our study and the patients were stratified into two groups based on the treatment.Nineteen patients in Group A were percutaneously treated by radiofrequency ablation(RFA) with computed tomographic (CT) guidance.Thirteen patients in Group B only underwent RFA for hematogenous metastases,but did not undergo any other treatment for metastatic lymph nodes.Follow-up contrast material-enhanced CT or positron emission tomographic(PET) scans were reviewed and Kaplan-Meier survival estimates were analyzed.Results The local control rate of 3,6,10,15months in Group A was 78.9％,73.3％,41.7％,25.0％ respectively.Kaplan-Meier analysis indicated the patients of Group A had an overall survival of 26.3％ at one year compared with 7.7％ for those of Group B.Mantel-Cox log rank test showed the one-year survival rate of Group A was significantly higher than that of Group B (P =0.029).There was no thermal injury of gastrointestinal tract or bile duct during RF ablation in Group A.Conclusion CT-guided RFA are effective and may be safely applied to retroperitoneal metastatic lymph nodes from PHC.