中国癌症杂志 ›› 2017, Vol. 27 ›› Issue (12): 959-963.doi: 10.19401/j.cnki.1007-3639.2017.12.007

• 论著 • 上一篇    下一篇

经皮射频消融术治疗外科切除术后复发性肝细胞癌疗效分析

袁筑慧,王 洋,李 威   

  1. 首都医科大学附属北京佑安医院肝病与肿瘤介入治疗中心,北京100069
  • 出版日期:2017-12-30 发布日期:2018-01-11
  • 通信作者: 李 威 E-mail: vision988@126.com
  • 基金资助:
    北京市卫生系统高层次人才资助项目(2014-3-088);国家重大科研装备研制项目(ZDYZ2015-2)。

The efficacy of radiofrequency ablation for recurrent hepatocellular carcinoma after hepatectomy

YUAN Zhuhui, WANG Yang, LI Wei   

  1. Center of Interventional Oncology and Liver Diseases, Beijing You’an Hospital, Capital Medical University, Beijing 100069, China
  • Published:2017-12-30 Online:2018-01-11
  • Contact: LI Wei E-mail: vision988@126.com

摘要: 背景与目的:大部分复发性的肝癌结节的直径小于3 cm,且射频消融(radiofrequency ablation,RFA)治疗直径小于3 cm的肿瘤结节,其疗效已受到广泛认可。探讨RFA对手术切除术后复发性肝细胞癌(hepatocellular carcinoma,HCC)的临床疗效与安全性。方法:回顾性分析61例手术切除后复发性HCC患者在经动脉化疗栓塞(transcatheter arterial chemoembolization,TACE)结合RFA的治疗下的1、3、5年总生存(overall survival,OS)率和无进展生存(progression-free survival,PFS)率,并发症发生率,死亡率,完全消融率以及影响患者生存率的独立风险因子。结果:完全消融率为93.4%(57/61),不完全消融率6.6%(4/61)。1、3、5年生存率分别为96.3%、77.9%和77.9%。1、3、5年PFS率分别为48.6%、20.3%和13.5%。消融术后出现主要并发症的患者1例,为肝包膜下出血;无消融治疗相关的死亡患者;消融后住院时间为4~7 d,中位值为5 d。影响OS的独立风险因子为患者HBsAg阳性(P=0.044,HR=7.496,95%CI:1.057~53.152)。结论:RFA治疗手术切除术后复发的HCC安全、有效,能够有效提高切除术后复发性HCC患者的生存率,对改善HCC患者的预后具有重要意义。

关键词: 肝细胞癌, 复发, 射频消融

Abstract: Background andpurpose: The majority of recurrent hepatocellular carcinoma (HCC) is small nodule with less than 3 cm in diameter, and the treatment of radiofrequency ablation (RFA) is associated with a prolonging survival time in patients with small HCC. This study aimed to explore the efficacy and safety of RFA for recurrent HCC. Methods: The 1-, 3- and 5-year overall survival (OS) rate and progression-free survival (PFS) rate of 61 patients with recurrent HCC undergoing transcatheter arterial chemoembolization (TACE) and RFA after hepatectomy were retrospectively evaluated by the Kaplan-Meier method. Furthermore, the complication rate, mortality rate and prognostic factor for OS were evaluated in this study. Results: The 1-, 3-, and 5-year OS rates were 96.3%, 77.9% and 77.9%, respectively. The 1-, 3-, and 5-year PFS rates were 48.6%, 20.3% and 13.5%, respectively. Fifty-seven patients (93.4%) achieved complete ablation. There was one patient with a major complication, and no death case due to RFA was found. The median length of hospitalization was 5 days (quartile, 4-7). The prognostic factor for OS was the expression of HBsAg (P=0.044, HR=7.496, 95%CI: 1.057-53.152). Conclusion: RFA was a safe and effective treatment modality for recurrent HCC after hepatectomy.

Key words: Hepatocellular carcinoma, Recurrence, Hepatectomy, Radiofrequency ablation