肝切除并微波消融与TACE治疗多发性肝癌的疗效比较  

Hepatectomy in combination with microwave ablation versus transcatheter arterial chemoembolization for the treatment of multifocal hepatocellular carcinoma:a comparative study

作　　者：冯钜涛[1] 李君[1] 方天翎[1] 岑钧华[1] 

机构地区：[1]广州医学院第一附属医院肝胆外科,广东广州510120

出　　处：《广州医学院学报》2012年第2期41-44,共4页Academic Journal of Guangzhou Medical College

基　　金：广东省自然科学基金(9151008901000186)

摘　　要：目的:比较肝切除并微波消融术与经肝动脉化疗栓塞术(TACE)治疗多发性肝癌的疗效方法:回顾性分析本科2007年1月至2008年8月收治的61例多发性肝癌患者,其中28例行肝切除并微波消融术(肝切除组),33例行TACE治疗(TACE组)。治疗后所有患者随访,Kaplan-Meier法分析组间生存差异。结果:两组患者均无住院期间死亡。肝切除组术后2个月AFP下降较TACE组明显(P<0.01)。肝切除组的1、2、3年生存率分别为75%、57.1%、35.7%,中位生存期26.5个月,显著高于TACE组的69.7%、30.3%、12.1%及18个月(P<0.05)。结论:对可耐受手术的多发性肝癌患者,肝切除并微波消融术安全有效,相对TACE能进一步提高患者3年生存率。Objective：To compare the efficacy of hepatectomy in combination with microwave ablation versus transcatbeter arterial chemoembolization （TACE） for the treatment of muhifocal hepatocellular carcinoma. Methods： In the current retrospective study, sixty-one patients with multifocal hepatocellular carcinoma were enrolled from the Department of Hepatobiliary Surgery, First Affiliated Hospital of Guangzhou Medical College between January 2007 and August 2008 and were allocated into hepatectomy group （n = 28 ） to receive hepatectomy in combination with microwave ablation and TACE group （ n = 33 ） to be treated with TACE therapy, respectively. All patients were followed up for computation of the distinction in survival rate via Kaplan-Meier method. Results：No death was reported during hospitalization postoperatively. The hepatectomy group yielded marked reduction in AFP level 2 months postoperatively compared with TACE group （P 〈 0.01 ）. The 1-, 2-and 3-year survival rates of hepatectomy group （75% ,57.1% and 35.7%, respectively） as well as median survival time （26.5 months） were significantly higher （all P 〈 0.05） than those of TACE group （69.7%, 30.3%, 12. 1% and 18 months, respectively）. Conclusion： Hepatectomy in combination with microwave ablation could be a safe and effective approach for patients with muhifocal hepatocellular carcinoma who are tolerable to surgical resection as a resuh of superior improvement in the 3-year survival rate as compared with TACE.

关 键 词：肝细胞癌 肝切除术 微波消融术 经肝动脉化疗栓塞术 

分 类 号：R735.7[医药卫生—肿瘤]