中国实用外科杂志

中国实用外科杂志

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再次肝切除与射频消融治疗复发性肝癌疗效对比研究

陈    康1，刘新宇1，滕煜宪1,2[Author]) AND 1[Journal]) AND year[Order])" target="_blank">2[Author]) AND 1[Journal]) AND year[Order])" target="_blank">2[Author]) AND 1[Journal]) AND year[Order])" target="_blank">2，李旻骏1,2[Author]) AND 1[Journal]) AND year[Order])" target="_blank">2[Author]) AND 1[Journal]) AND year[Order])" target="_blank">2[Author]) AND 1[Journal]) AND year[Order])" target="_blank">2，黎宇松1,2[Author]) AND 1[Journal]) AND year[Order])" target="_blank">2[Author]) AND 1[Journal]) AND year[Order])" target="_blank">2[Author]) AND 1[Journal]) AND year[Order])" target="_blank">2，黄    韬1,3，马    良1,3，袁卫平1,3，向邦德1,3，钟鉴宏1,3，黎乐群1,3   

  1. 1广西医科大学附属肿瘤医院肝胆外科，广西南宁530021；2广西医科大学基础医学院2016级，广西南宁 530021；3广西肝癌诊疗工程技术研究中心，广西南宁 530021
  • 出版日期:2019-10-01 发布日期:2019-10-10

  • Online:2019-10-01 Published:2019-10-10

摘要：

目的    比较再次肝切除术和射频消融（RFA）治疗复发性肝癌的安全性和疗效。方法    回顾性分析2005年1月至2014年12月广西医科大学附属肿瘤医院收治的行再次肝切除术（77例）和RFA（82例）的复发性肝癌病人临床资料，使用倾向性匹配分析方法均衡基线资料，采用Kaplan-Meier 法进行生存分析。结果    倾向性匹配分析筛选出41对病人。RFA组病人的围手术期病死率和并发症发生率更低，住院时间更短。以再次肝切除术（或RFA）的时间为起点，或以首次肝切除术的时间为起点统计总存活率，两组病人的总存活率差异均无统计学意义（P=0.258、0.820）；倾向性匹配后，两组病人的总存活率差异亦无统计学意义（P=0.443、0.917）。结论    对于符合适应证的复发性肝癌，RFA安全性较好，病人住院时间短，且远期存活率与再次肝切除术相近。

关键词: 复发性肝癌, 肝切除术, 射频消融

Abstract:

Rehepatectomy and radiofrequency ablation for patients with recurrent hepatocellular carcinoma        CHEN Kang*，LIU Xin-yu，TENG Xu-xian，et al. *Department of Hepatobiliary Surgery，Guangxi Medical University Cancer Hospital，Nanning 530021，China
Corresponding author：ZHONG Jian-hong，E-mail：zhongjianhong@gxmu.edu.cn；LI Le-qun，E-mail：li_lequn@263.net
Abstract    Objective    To observe the safety and efficacy of rehepatectomy and radiofrequency ablation for patients with recurrent hepatocellular carcinoma（HCC）. Methods    A consecutive sample of 159 recurrent HCC patients who underwent rehepatectomy (n=77) or radiofrequency ablation (n=82) from January 2005 to December 2014 were analyzed retrospectively. Propensity score analysis was used. The Kaplan-Meier method was used for survival analysis. Results Propensity score analysis chose 41 pair patients. Patients in the radiofrequency ablation group were with lower rate of perioperative mortality and morbidiy，shorter length of hospital stay. When calculate the survival time from the date of rehepatectomy or radiofrequency ablation，or calculate the survival time from the date of the first hepatectomy，the two arms showed similar overall survival (P=0.258，0.820). Moreover，overall survival were similar after propensity score analysis (P=0.443，0.917). Conclusion    Radiofrequency ablation was safety，associated with shorter length of hospital stay and similar long-term overall survival with rehepatectomy for recurrent HCC.

Key words: recurrent hepatocellular carcinoma, hepatectomy, radiofrequency ablation