多电极射频消融与手术切除治疗中肝癌对比分析

Comparison of effects of percutaneous radiofrequency ablation with multiple electrodes and surgical resection on medium-sized hepatocellular carcinomas

目的对比分析多电极经皮射频消融(PRFA)与手术切除治疗中肝癌(肿瘤最大直径3~5 cm)的疗效。方法回顾性分析2014年4月至2016年4月就诊于郑州大学第一附属医院肝胆胰脾外科的30例多电极经皮射频消融术(组1)和同期30例行手术切除治疗中肝癌的患者(组2),比较两组术后住院天数、术后并发症、术后1年和2年生存率及无瘤生存率差异情况。结果组1术后1、2年无瘤生存率和生存率分别是76.7%、53.3%和93.3%、86.7%。组2术后1、2年无瘤生存率及生存率分别为83.3%、66.7%和96.7%、90.0%。两组术后1、2年无瘤生存率及生存率比较,差异均无统计学意义(P>0.05)。组1术后平均住院天数(6.37±2.32)d短于组2的(11.41±2.58)d,差异有统计学意义(P<0.05)。组1术后并发症发生率3.33%低于组2的30.0%,差异有统计学意义(P<0.05)。结论多电极经皮射频消融与手术切除治疗中肝癌比较,生存率及无瘤生存率无明显差异,但能显著缩短患者术后住院天数,降低术后并发症发生率。

Objective To compare the effect of percutaneous radiofrequency ablation （PRFA） with multiple electrodes and surgical resection as an initial treatment for patients with medium - sized （3 - 5 cm in diameter） hepatoeellular carcinoma （HCC）. Methods 30 patients with medium - sized HCC （ with single nodule 3 - 5 em in diameter） underwent ultrasound - guided percutaneous RFA with multiple electrodes（ group 1 ） at Department of Hepatobiliary and Pancreatic Surgery in the First Affiliated Hospital of Zhengzhou University from April of 2014 to April of 2016, and the same period of 30 cases underwent open liver resection surgery （ group 2） were retrospectively analyzed. The number of days of hospitalization, the postoperative compli- cations, 1 - year and 2 - year survival rate and disease - free survival of discrepancy were compared. Results 1 - and 2 - year survival rates of Group 1 were 93.3% , 86. 7 % , disease - free survival rates were 76. 7% , 53.3% , while 1 - and 2 - year sur- vival rates were 96. 7% , 90% , disease - free survival were 83.3% , 66. 7% in group 2. Disease - free survival and survival rates between two groups were not significantly different （ P 〉 0.05 ）. The number of days of hospitalization of group 1 was （6. 37 ＋-2. 32） days, while group 2 was （ 11.41 ＋-2. 58） days, and the difference was statistically significant （P 〈0. 05）. The postoperative complications of group 1 was 3.33% , while group 2 was 30. 0%, and the difference was statistically significant （ P 〈 0. 05 ）. Conclusion PRFA with multiple electrodes treatment is equally effective as surgical resection for medium - sized HCC, but it is less invasive with quicker recovery.