摘要
背景与目的:射频消融(radiofrequencyablation,RFA)治疗作为肝癌局部治疗的新技术,近年得到了广泛的应用。本研究分析肝癌RFA治疗的疗效和复发相关因素,并探索RFA治疗的适应证。方法:采用回顾性队列研究方法,分析2001年1月至2003年12月期间,94例在中山医院肝癌研究所行RFA治疗的原发性小肝癌患者的102个病灶,随访期至2004年3月。采用SPSS11.5统计软件对数据进行处理。结果:94例患者的中位随访期为16个月,RFA治疗后的1年累积生存率为85.5%,2年累积生存率为75.6%;1年累积无瘤生存率为31.3%,2年累积无瘤生存率为10.4%。共有62例患者(66.0%)复发。单因素分析显示复发与下列3个因素有关:肿瘤近血管(P<0.01)、位于肝包膜下(P<0.05)、直径>3cm(P<0.05);而与性别、Child分级、AFP值、是否联合瘤内无水乙醇注射治疗无关。Cox多因素分析显示:肿瘤近血管(P=0.000,95%可信区间为2.102～7.899)、位于肝包膜下(P=0.001,95%可信区间为1.672～6.289)是RFA治疗后复发的独立危险因素。较严重并发症的发生率为2.1%(2/94,胆道出血1例,膈下积液1例)。未发生与手术相关的死亡。结论:RFA是一种安全的肝癌治疗方法。直径≤3cm、不近肝内血管、非包膜下肿块是肝肿瘤RFA治疗的适应证。
BACKGROUND &OBJECTIVE:As a new technique of local therapy for li ve r cancer, radiofrequency ablation (RFA) was widely used these years in China. Th is study was to evaluate the treatment efficacy of RFA on primary liver cancer ( PLC), identify the risk factors of recurrence, and determine the indications of RFA for PLC. METHODS: Records of 94 primary small liver cancer patients underwen t a single session of percutaneous RFA in Liver Cancer Institute/Zhongshan Hospi tal from Jan. 2001 to Dec. 2003 were reviewed retrospectively. Data analyses wer e performed using SPSS for windows Ver. 11.5 software. RESULTS:With a median fo llow-up of 16 months affer RFA treatment, the cumulative survival rate of 94 pa tients was 85.5%at 1 year, and 75.6%at 2 years. The cumulative recurrence-fre e survival rate was 31.3%at 1 year, and 10.4%at 2 years. The total recurrence rate was 66.0%(62/94). Log-rank test revealed that tumor with diameter of >3 c m (P< 0.05), proximity to intrahepatic vessels (P < 0.01), and subcapsular locat ion (P< 0.05) were related to tumor recurrence,while gender, Child-pugh class, alpha fetoprotein (AFP) concentration, and combination therapy with percutaneous ethanol injection were not related to tumor recurrence. Cox regression analysis indicated that tumor proximity to intrahepatic vessels (95%CI, 2.102-7.899; P =0.000), and subcapsular location (95%CI, 1.672-6.289; P=0.001)were associated independently with recurrence after RFA treatment. Severe complications occurre d in 2 cases (2.1%), including 1 case of bile duct hemorrhage, 1 case of sub-d iaphragm effusion. No RFA related death and other severe complications occurred. CONCLUSIONS:RFA appears to be a safe treatment for liver cancer. Patients with tumor diameter of ≤3 cm, no proximity to intrahepatic vessels, and subcapsular location may be the most suitable candidates for RFA.
出处
《癌症》
SCIE
CAS
CSCD
北大核心
2004年第9期977-980,共4页
Chinese Journal of Cancer
关键词
原发性肝癌
射频消融
预后
复发
危险因素
Primary liver cancer (PLC)
Radiofrequency ablation (RFA)
Prognosis
Recurrence
Risk factors
