肝脏
肝髒
간장
Chinese Hepatology
2015年
11期
851-854,898
,共5页
复发性肝癌%重复手术%射频消融%肝动脉栓塞化疗
複髮性肝癌%重複手術%射頻消融%肝動脈栓塞化療
복발성간암%중복수술%사빈소융%간동맥전새화료
Recurrent hepatocellular carcinoma%Retreatment with resection%Radiofrequency ablation%TACE
目的:比较重复手术切除、射频消融(RFA)及肝动脉栓塞化疗(TACE)对复发性肝癌的治疗价值。方法回顾性分析2008年1月至2013年12月在延安大学附属医院肝胆外科治疗的原发性肝细胞癌(HCC)患者,对肿瘤复发者采用重复手术切除、RFA 或 TACE 单一治疗并进行随访,评价三种技术对复发性肝癌的治疗效果。结果符合入选标准患者83例,其中重复手术切除18例、RFA 20例、TACE 45例。早期复发(≤12个月)患者中肝内转移(IM)和多中心发生(MO)分别为29例和7例,晚期复发分别为9例和38例(P <0.01);TACE 和重复切除/RFA 在早期复发和晚期复发分布差异无统计学意义(P =0.83);TACE 组与重复切除/RFA 组生存率组间比较差异无统计学意义(P =0.191),早期复发与晚期复发患者生存率组间比较差异无统计学意义(P =0.101),早期复发患者中 TACE 组与重复切除/RFA 生存率组间比较差异无统计学意义(P =0.223),而晚期复发患者中重复切除/RFA 组生存率高于 TACE 组(P =0.025)。结论应该根据 IM 和 MO 选择 HCC 肝内复发的治疗方法,对于早期复发者 TACE 疗效与重复切除和 RFA 相近,而对于晚期复发者重复切除或 RFA 疗效优于 TACE。
目的:比較重複手術切除、射頻消融(RFA)及肝動脈栓塞化療(TACE)對複髮性肝癌的治療價值。方法迴顧性分析2008年1月至2013年12月在延安大學附屬醫院肝膽外科治療的原髮性肝細胞癌(HCC)患者,對腫瘤複髮者採用重複手術切除、RFA 或 TACE 單一治療併進行隨訪,評價三種技術對複髮性肝癌的治療效果。結果符閤入選標準患者83例,其中重複手術切除18例、RFA 20例、TACE 45例。早期複髮(≤12箇月)患者中肝內轉移(IM)和多中心髮生(MO)分彆為29例和7例,晚期複髮分彆為9例和38例(P <0.01);TACE 和重複切除/RFA 在早期複髮和晚期複髮分佈差異無統計學意義(P =0.83);TACE 組與重複切除/RFA 組生存率組間比較差異無統計學意義(P =0.191),早期複髮與晚期複髮患者生存率組間比較差異無統計學意義(P =0.101),早期複髮患者中 TACE 組與重複切除/RFA 生存率組間比較差異無統計學意義(P =0.223),而晚期複髮患者中重複切除/RFA 組生存率高于 TACE 組(P =0.025)。結論應該根據 IM 和 MO 選擇 HCC 肝內複髮的治療方法,對于早期複髮者 TACE 療效與重複切除和 RFA 相近,而對于晚期複髮者重複切除或 RFA 療效優于 TACE。
목적:비교중복수술절제、사빈소융(RFA)급간동맥전새화료(TACE)대복발성간암적치료개치。방법회고성분석2008년1월지2013년12월재연안대학부속의원간담외과치료적원발성간세포암(HCC)환자,대종류복발자채용중복수술절제、RFA 혹 TACE 단일치료병진행수방,평개삼충기술대복발성간암적치료효과。결과부합입선표준환자83례,기중중복수술절제18례、RFA 20례、TACE 45례。조기복발(≤12개월)환자중간내전이(IM)화다중심발생(MO)분별위29례화7례,만기복발분별위9례화38례(P <0.01);TACE 화중복절제/RFA 재조기복발화만기복발분포차이무통계학의의(P =0.83);TACE 조여중복절제/RFA 조생존솔조간비교차이무통계학의의(P =0.191),조기복발여만기복발환자생존솔조간비교차이무통계학의의(P =0.101),조기복발환자중 TACE 조여중복절제/RFA 생존솔조간비교차이무통계학의의(P =0.223),이만기복발환자중중복절제/RFA 조생존솔고우 TACE 조(P =0.025)。결론응해근거 IM 화 MO 선택 HCC 간내복발적치료방법,대우조기복발자 TACE 료효여중복절제화 RFA 상근,이대우만기복발자중복절제혹 RFA 료효우우 TACE。
Objective To evaluate therapeutic values of retreatment with resection,radiofrequency ablation (RFA) and transcatheter arterial chemoembolization (TACE)for intrahepatic recurrent cancer.Methods Patients administered resection of hepatocellular carcinoma (HCC)from January 2008 to December 2013 in our hospital were retrospectively analyzed.Cases accepted monotherapy as retreatment with resection,RFA or TACE for tumor recurrence were followed up.In addition,efficacy among three different types of therapy were evaluated.Results Eighty-three patients were enrolled,including 18 patients received retreatment with resection,20 received RFA and 45 received TACE.Among those patients,early recurrence (≤12 months)occurred in 36 cases,including 29 cases with intrahepatic metastasis (IM)and 7 cases with multi-centric occurrence (MO),while late recurrence occurred in 47 cases,including 9 cases with IM and 38 cases with MO (P <0.01 ).There was no significant difference in recurrence phases (P =0.83)and survival rate (P =0.191)between TACE group and retreatment with resection/RFA group.Also no significant difference was found in survival rate between early recurrence group and late recurrence group (P =0.101).In early recurrence group,there was no significant difference in survival rate between TACE group and retreatment with resection/RFA group (P =0.223).While in late recurrence group,survival rate of retreatment with resection/RFA group was higher than that in TACE group (P =0.025).Conclusion Treatment for intrahepatic recurrence of HCC patients should be based on metastasis status,IM or MO.Similar efficacy was observed in TACE and retreatment with resection/RFA in early recurrence,while retreatment with resection/RFA was more effective than TACE in late recurrence.