经皮微波消融与肝切除治疗肝细胞肝癌的疗效比较  

Comparison of the effectiveness of percutaneous microwave ablation versus hepatectomy for hepatocellular carcinoma

作　　者：黎升[1] 王薏淇[1] 董军[1] 吴沛宏[1] 

机构地区：[1]中山大学附属肿瘤医院医学影像与微创介入治疗中心华南肿瘤学国家重点实验室肿瘤医学协同创新中心,广州510060

出　　处：《中华肿瘤杂志》2015年第4期301-307,共7页Chinese Journal of Oncology

基　　金：国家高技术研究发展计划（2012AA022701）

摘　　要：目的分析经皮微波消融与肝切除治疗2～4个病灶肝细胞癌的疗效。方法2002年8月至2012年3月间收集122例2～4个病灶肝癌患者的临床资料，肿瘤大小为1～7cm，均行完全微波消融或根治性切除术。切除组根据临床特征与微波组患者匹配，选取行肝切除术的患者72例，比较两组患者的生存情况。结果微波组患者的1、3、5年生存率为100．0％、73．0％和62．0％，切除组分别为80．0％、56．0％和41．0％，差异有统计学意义（P〈0．05）。微波组患者的1、3、5年无复发生存率分别为88．0％、63．0％和52．0％，切除组分别为68．0％、45．0％和36．0％，差异有统计学意义（P〈0．05）。多因素分析结果显示，白蛋白水平、美国东部肿瘤协作组评分、治疗方式和肿瘤大小是影响肝癌患者预后的独立因素（均P〈0．05）。结论微波消融微创、重复性好。与肝切除术比较，微波消融能延长2～4个病灶肝细胞癌患者的生存时间。Objective To compare the effectiveness of percutaneous microwave ablation （MWA） versus hepatectomy for multifocal hepatocellular carcinoma. Methods From August 2002 to March 2012, one hundred and twenty-two patients with multifocal hepatocellular carcinoma （diameters 1 to 7 cm, 2 to 4 lesions） were treated by either complete MWA or radical hepatectomy, and their clinical data were collected and analyzed.The patients were divided into MWA group （n= 50） and resection group（n= 72）, and the resection group was matched by MWA group based on clinical parameters. The survival and complications in the two groups were compared. Results The overall 1-, 3- and 5-year survival rates were 100.0%, 73.0% and 62.0%, respectively, in the MWA group, and 80.0%, 56.0%, and 41.0%, respectively, in the resection group （ P 〈 0.05）. The corresponding recurrence-free survival rates were 88.0%, 63.0%, and 52.0% in the MWA group, and 68.0%, 45.0%, and 36.0%, respectively, in the resection group （P〈 0.05）. The multivariate Cox regression analysis indicated that albumin level, performance status, treatment modality, and tumor size were independent prognostic factors. Conclusion Compared with hepatectomy, percutaneous microwave ablation is a minimally invasive and reproducible procedure, and can improve the survival in patients with muhifocal hepatocellular carcinoma.

关 键 词：肝肿瘤 消融技术 肝切除术 治疗结果 预后 

分 类 号：R735.7[医药卫生—肿瘤]