摘要
经过三十年的发展和推广,射频消融已成为肝细胞癌(HCC)常用的局部消融治疗手段,成为了早期和很早期HCC的首选治疗手段以及进展期HCC综合治疗中的重要辅助性措施,在一定程度上改变了传统HCC治疗模式。近十多年来,在HCC早期诊断率越来越高、基础肝病的内科治疗越来越规范和普及的背景下,传统的肝切除术借助腹腔镜、肝段/叶染色等技术的广泛应用,在HCC治疗的安全性、有效性和微创性等方面均获得了实质性进步,对射频消融的学术地位形成了强有力的挑战。越来越多的证据表明,在射频消融最优势领域——早期和很早期HCC,肝切除术的中远期疗效明显优于射频消融;而射频消融在治疗理念和技术等方面缺乏创新性进步和体系性推进,总体疗效缺乏实质性提升。本文对当前射频消融在HCC综合治疗中学术地位的困境、原因及其应对措施进行了总结。
Radiofrequency ablation (RFA) has become the most commonly used means of local ablation for hepatocellular carcinoma (HCC), the first choice for early HCC and an important auxiliary treatment for advanced HCC after 30 years of development and promotion, which, to a certain extent, has replaced the traditional model of HCC treatment. In the recent decade or more, the early diagnosis rate of HCC has been higher and higher, and the medical treatment of the underlying liver diseases is becoming more and more normalized and popular, the traditional liver resection has obtained substantial progress in safety, efficacy and minimally invasiveness with the aid of laparoscopy, liver segment dyeing technique etc. These progresses have formed a big challenge to the academic role of RFA in the comprehensive treatment of HCC. A growing body of evidence shows that liver resection is significantly superior to RFA for early and very early HCC which is the most advantageous area of RFA. In contrast, in the same period RFA is lack of innovative progress and systematic promotion in treatment concept and technology, and the overall efficacy is lack of substantial improvement. The present paper summarizes the plight that RFA is facing, the reasons and the solutions of the plight.
作者
孙文兵
Sun Wenbing(Department of Hepatobiliary-pancreatic-splenic Surgery,West Campus,Beijing Chaoyang Hospital,Capital Medical University,Beijing 100043,China)
出处
《中华肝胆外科杂志》
CAS
CSCD
北大核心
2020年第6期401-405,共5页
Chinese Journal of Hepatobiliary Surgery
基金
国家自然科学基金(81572957)
北京市石景山区医学重点学科建设项目(20130001)。
关键词
癌
肝细胞
射频消融
肝切除术
疗效
困境
Carcinoma,hepatocellular
Radiofrequency ablation
Liver resection
Efficacy
Plight
