AIM: To evaluate the factors affecting the early tumor recurrence within one year in cirrhotic patients having a single small hepatocellular carcinoma (HCC) after complete tumor necrosis by radiofrequency ablation (RF...AIM: To evaluate the factors affecting the early tumor recurrence within one year in cirrhotic patients having a single small hepatocellular carcinoma (HCC) after complete tumor necrosis by radiofrequency ablation (RFA)therapy.METHODS: Thirty patients with a single small HCC received RFA therapy by a RFA 2000 generator with LeVeen needle. Tri-phase computerized tomogram was followed every 2 to3 mo after RFA. The clinical effects and tumor recurrence were recorded.RESULTS: The initial complete tumor necrosis rate was 86.7%. Twenty-two patients were followed for more than one year. The local and overall recurrence rates were 13.6% and 36.4%, 33.3% and 56.2%, 46.6% and 56.2%at 12, 24 and 30 mo, respectively. No major complication or procedure-related mortality was found. The risk factors for early local tumor recurrence within one year were larger tumor size, poor pathologic differentiation of tumor cells and advanced tumor staging. The age of patients with new tumor formation within one year was relatively younger (55.1±8.3 vs 66.7±10.8, P = 0.029).CONCLUSION: Large tumor size, poor pathologic differentiation of tumor cells and advanced tumor staging are the risk factors for early local tumor recurrence within one year, and young age is the positive predictor for new tumor formation within one year.展开更多
AIM： To evaluate the therapeutic effect and the indication of percutaneous ethanol injection （PEI）, radiofrequency ablation （RFA） and their combination in treatment of hepatocellular carcinoma （HCC）. METHODS： ...AIM： To evaluate the therapeutic effect and the indication of percutaneous ethanol injection （PEI）, radiofrequency ablation （RFA） and their combination in treatment of hepatocellular carcinoma （HCC）. METHODS： Two hundred and fifty-five patients with HCC received treatment of PEI, RFA or their combination. Group1 （〈 3 on in diameter, n=85） was treated with PEI, group2 （〈 3 cm in diameter, n=153） with RFA. Group3 （〉3 cm in diameter, n=86） was divided into two groups. Group 3a （/7=34） was treated with RFA, while group 3b （n=52） was treated with RFA for 2 wk after transcatheter arterial chemoembolization or PEI. Contrast-enhanced sonography was performed for 61 patients before and after RFA. Liver function and serum alpha-fetoprotein （AFP） were measured for all patients. Changes of the lesions on ultrasound and contrast-enhanced CT/HRI were evaluated for assessing the therapeutic responses. The 1-, 2-, 3- and 5-year survival rates were recorded after treatment. RESULTS： In group 1, the complete necrosis rate of lesions after 1 mo was 77.6% （66/85）. The level of AFP declined conspicuously after 1 mo. The 1-, 2-, 3- and 5-year survival rate after treatment was 80.0% （52/65）, 60.4% （32/53）, 52.5% （21/40） and 33.3% （7/21）, respectively. In group 2, the complete necrosis rate of lesions after 1 moh was 92.2% （141/153）. The level of AFP decreased conspicuously after i mo. The 1-, 2-, 3- and 5-year survival rate after treatment was 94.6% （88/93）, 73.2% （52/71）, 63.5% （33/52） and 46.4% （13/28）, respectively. In group 3a, the complete necrosis rate of lesions after 1 mo was 23.5% （8/34）. AFPdropped down to the normal level in only one patient after 1 mo. The 1-, 2- and 3-year survival rate after treatment was 47.6% （10/21）, 42.9% （6/14） and 27.3% （3/11）, respectively. Only one patient was still alive after 5 years. In group 3b, the complete necrosis rate of lesions after 1 mo was 57.7% （30/52）. The level of AFP decreased after 1 mo. The 1-, 2-, 3- and S-year survival rate after treatment was 68.6% （24/35）, 46.2% （12/26）, 36.8% （7/19） and 27.3% （3/11）, respectively. CONCLUSION： The therapeutic effect of RFA on small HCC is better than that of PEI. Small HCC is the optimal indication of RFA. For recurrent HCC （diameter〉3 cm）, the combined treatment of RFA and PEI/ACE should be used.展开更多
基金Supported by the Research Grants VGHKS-92104 from Kaohsiung Veterans General Hospital, Taiwan, China
文摘AIM: To evaluate the factors affecting the early tumor recurrence within one year in cirrhotic patients having a single small hepatocellular carcinoma (HCC) after complete tumor necrosis by radiofrequency ablation (RFA)therapy.METHODS: Thirty patients with a single small HCC received RFA therapy by a RFA 2000 generator with LeVeen needle. Tri-phase computerized tomogram was followed every 2 to3 mo after RFA. The clinical effects and tumor recurrence were recorded.RESULTS: The initial complete tumor necrosis rate was 86.7%. Twenty-two patients were followed for more than one year. The local and overall recurrence rates were 13.6% and 36.4%, 33.3% and 56.2%, 46.6% and 56.2%at 12, 24 and 30 mo, respectively. No major complication or procedure-related mortality was found. The risk factors for early local tumor recurrence within one year were larger tumor size, poor pathologic differentiation of tumor cells and advanced tumor staging. The age of patients with new tumor formation within one year was relatively younger (55.1±8.3 vs 66.7±10.8, P = 0.029).CONCLUSION: Large tumor size, poor pathologic differentiation of tumor cells and advanced tumor staging are the risk factors for early local tumor recurrence within one year, and young age is the positive predictor for new tumor formation within one year.
基金Supported by the Natural Science Foundation of Guangdong province of China No.31710the Medical Research Foundation of the Bureau of Health of Guangdong Province of China No.A2003203
文摘AIM： To evaluate the therapeutic effect and the indication of percutaneous ethanol injection （PEI）, radiofrequency ablation （RFA） and their combination in treatment of hepatocellular carcinoma （HCC）. METHODS： Two hundred and fifty-five patients with HCC received treatment of PEI, RFA or their combination. Group1 （〈 3 on in diameter, n=85） was treated with PEI, group2 （〈 3 cm in diameter, n=153） with RFA. Group3 （〉3 cm in diameter, n=86） was divided into two groups. Group 3a （/7=34） was treated with RFA, while group 3b （n=52） was treated with RFA for 2 wk after transcatheter arterial chemoembolization or PEI. Contrast-enhanced sonography was performed for 61 patients before and after RFA. Liver function and serum alpha-fetoprotein （AFP） were measured for all patients. Changes of the lesions on ultrasound and contrast-enhanced CT/HRI were evaluated for assessing the therapeutic responses. The 1-, 2-, 3- and 5-year survival rates were recorded after treatment. RESULTS： In group 1, the complete necrosis rate of lesions after 1 mo was 77.6% （66/85）. The level of AFP declined conspicuously after 1 mo. The 1-, 2-, 3- and 5-year survival rate after treatment was 80.0% （52/65）, 60.4% （32/53）, 52.5% （21/40） and 33.3% （7/21）, respectively. In group 2, the complete necrosis rate of lesions after 1 moh was 92.2% （141/153）. The level of AFP decreased conspicuously after i mo. The 1-, 2-, 3- and 5-year survival rate after treatment was 94.6% （88/93）, 73.2% （52/71）, 63.5% （33/52） and 46.4% （13/28）, respectively. In group 3a, the complete necrosis rate of lesions after 1 mo was 23.5% （8/34）. AFPdropped down to the normal level in only one patient after 1 mo. The 1-, 2- and 3-year survival rate after treatment was 47.6% （10/21）, 42.9% （6/14） and 27.3% （3/11）, respectively. Only one patient was still alive after 5 years. In group 3b, the complete necrosis rate of lesions after 1 mo was 57.7% （30/52）. The level of AFP decreased after 1 mo. The 1-, 2-, 3- and S-year survival rate after treatment was 68.6% （24/35）, 46.2% （12/26）, 36.8% （7/19） and 27.3% （3/11）, respectively. CONCLUSION： The therapeutic effect of RFA on small HCC is better than that of PEI. Small HCC is the optimal indication of RFA. For recurrent HCC （diameter〉3 cm）, the combined treatment of RFA and PEI/ACE should be used.
