早-中期原发性肝癌三种不同治疗方法的疗效比较：附428例分析  

A comparison of three different curative therapies for early-intermediate stage primary liver cancer analysis of 428 cases

作　　者：李传云[1] 卢实春[1] 赖威[1] 刘源[1] 曾道炳[1] 郭庆良[1] 林栋栋[1] 武聚山[1] 王孟龙[1] 李宁[1] 

机构地区：[1]首都医科大学附属北京佑安医院肝胆外科暨肝脏移植中心,100069

出　　处：《中华肝胆外科杂志》2011年第5期376-379,共4页Chinese Journal of Hepatobiliary Surgery

基　　金：国家自然科学基金资助项目（30671977）;首都医学发展基金资助项目（2005-2034）

摘　　要：目的比较三种不同方法治疗早-中期原发性肝癌的效果。方法回顾性分析本中心自2004年4月至2010年7月治疗的428例早中期原发性肝癌的临床资料，根据治疗方法的不同分为三组：手术切除（A）组231例、射频消融治疗（B）组63例、肝移植（C）组134例。比较三组患者的1、3、5年累计生存率及复发率。结果A组1、3、5年累计生存率分别为93．3％、71．9％、57．2％；B组为86．7％、46．5％、38．8％；C组为95．7％、78．3％、72．1％。A组1、3、5年累计复发率分别为30．3％、49．7％、68．6％；B组为39．3％、58．7％、79．3％；C组为7．0％、12．1％、12．1％。三组患者生存率及复发率差异显著。C组5年生存率显著高于A、B两组（P〈0．01，P〈0．001）。C组1、3、5年复发率均显著低于A组和B组（P〈0．001）。A组与B组复发率无显著差异。结论肝移植治疗早一中期原发性肝癌可获得较好的5年生存率及较低的近、远期肿瘤复发率，可作为首选治疗方案。Objective To compare the curative results of three different therapies for early- intermediate stage primary liver cancer. Methods The data of 428 patients with early intermediate stage primary liver cancer treated with one of three curative therapies from April 2004 to July 2010 in our center were analyzed retrospectively. The patients were divided non-randomly into three groups： group A liver-cancer resection （n = 231） , group B radio-frequency ablation （RFA） （n = 63）, and group C liver transplantation （n= 134）. The 1-, 3-, 5-year accululative survival and recurrence rate in each group were compared. Results The accumulative 1-, 3-, 5-year survival rates were 93.3%, 71.9%, 57.2% for group A; 86.7%, 46.5%, 38.8% for group B; 95.7%, 78.3%, 72.1% for group C,respectively. The 1-, 3-, 5-year recurrence rates were 30. 3 % , 49.7%, 68.6% for groupA; 39.3%, 58.7%, 79.3% for groupB; 7.0%, 12.1%, 12.1% for groupC,respectively. There wasa highly significant difference between groups A, t3 and C in the survival rates and the recurrence rates. The 5-year survival rate was significantly higher for group C than group A and group B （P〈0.01, P〈0. 001）, and the recurrence rate of 1, 3, 5 years were significantly lower for group C than for group A and B （P〈0. 001）. Conclusion Liver transplantation was the most effective therapy for the early-intermediate stage primary liver cancer.

关 键 词：肝癌 肝切除术 射频消融术 肝移植术 

分 类 号：R735.7[医药卫生—肿瘤]