二次手术与经皮射频消融术治疗复发性小肝癌对患者无瘤生存率的影响

Effect of Secondary Surgery and Percutaneous Radiofrequency Ablation on Tumor-free Survival Rate of Patients with Recurrent Small Hepatocellular Carcinoma

目的观察二次手术与经皮射频消融术治疗复发性小肝癌对患者无瘤生存率的影响。方法回顾性选取2018年6月-2021年12月龙岩市第二医院肝胆外科收治的复发性小肝癌(直径2~5 cm)患者60例,依据治疗措施不同将其分为消融组(n=32)、二次手术组(n=28),对比两组手术治疗一般情况、手术前后生化指标变化、并发症、复发率及无瘤生存情况。结果消融组治疗时间、术后住院时间短于二次手术组(P<0.05);消融组术后4周谷丙转氨酶(ALT)、谷草转氨酶(AST)、甲胎蛋白(AFP)低于二次手术组,而白蛋白(ALB)高于二次手术组(P<0.05);两组术后6个月复发率比较无统计学差异(P>0.05),消融组并发症发生率低于二次手术组(P<0.05);两组术后6个月平均无瘤生存时间、无瘤生存率无统计学差异(P>0.05)。结论二次手术与经皮射频消融术治疗复发性小肝癌均有一定疗效,后者有创伤小、肝功能损伤轻、并发症风险低等优势,无瘤生存率相当。

Objective To observe the effect of secondary surgery and percutaneous radiofrequency ablation on tumor-free survival rate of patients with recurrent small hepatocellular carcinoma.Methods This study retrospectively reviewed 60 patients with recurrent small hepatocellular carcinoma(2~5 cm in diameter)admitted to the Department of Hepatobiliary Surgery of our hospital from June 2018 to December 2021.The patients were divided into ablation group(n=32)and second surgery group(n=28)according to the treatment method.General surgical conditions,changes in biochemical indicators,complications,recurrence rate and disease-free survival were compared between the two groups.Results The treatment time and postoperative hospital stay of the ablation group were shorter than those of the second surgery group(P<0.05).At 4 weeks after operation,the levels of alanine aminotransferase(ALT),aspartate aminotransferase(AST)and alpha-fetoprotein(AFP)were lower,and the level of albumin(ALB)in the ablation group was higher than those in the second surgery group(P<0.05).The recurrence rates in the two groups in 6 months after operation were similar(P>0.05),and the incidence of complications in the ablation group was lower than that in the second surgery group(P<0.05).The mean tumor-free survival time and tumor-free survival rate in 6 months after operation showed no significant difference between the two groups(P>0.05).Conclusion Both secondary surgery and percutaneous radiofrequency ablation are effective in the treatment of recurrent small hepatocellular carcinoma.The latter has the advantages of less trauma,milder liver damage,and lower risk of complications.Patients treated with the two methods have similar tumor-free survival rates.