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目的比较经皮原位射频消融与手术切除治疗肝脏肿瘤的疗效。方法1999年11月至2004年6月,中山大学肿瘤防治中心共收治434例肝功能Child A级的小肝癌(单个肿瘤、直径≤5.0cm)病人。其中手术切除183例,射频消融治疗251例。结果手术切除组1、3、5年存活率分别为91.18%、70.18%、55.51%,射频消融组存活率分别为91.92%、74.41%、58.22%,两组之间差异无统计学意义(P=0.6253);分层分析显示,对于直径≤3.0cm肿瘤,手术切除组1、3、5年存活率分别为95.87%、73.69%、62.45%,射频消融组1、3、5年存活率分别为95.46%、80.15%、72.79%,两组之间差异无统计学意义(P=0.5641);对于直径3.1~5.0cm肿瘤,手术切除组1、3、5年存活率分别为88.07%、67.63%、51.18%,射频消融组1、3、5年存活率分别为80.16%、60.63%、32.34%,两组之间差异无统计学意义(P=0.1256);多因素分析显示肿瘤大小和总胆红素(serum bilirubin)是影响存活率的独立危险因素。结论对于肝功能较好的单个肿瘤的小肝癌病人,射频消融与手术切除效果相近,可达到根治性效果,可代替部分开腹手术切除。     

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近年来 ,随着计算机辅助影象以及腔镜外科技术的发展 ,一系列肿瘤原位灭活治疗技术应运而生。其中包括经皮穿刺酒精注射 (ｐｅｒｃｕｔａｎｅｏｕｓｅｔｈａｎｏｌｉｎｊｅｃｔｉｏｎ ,ＰＥＩ) ,冷冻治疗 (ｃｒｙｏａｂｌａｔｉｏｎ ,ＣＡ) ,激光 (ｌａｓｅｒａｂｌａｔｉｏｎ ,ＬＡ) ,微波 (ｍｉｃｒｏｗａｖｅａｂｌａｔｉｏｎ,ＭＷＡ) ,体外聚焦超声波 (ｆｏｃｕｓｅｄｕｌｔｒａｓｏｕｎｄ ,ＦＵＳ)以及射频组织灭活 (ｒａｄｉｏｆｒｅｑｕｅｎｃｙａｂｌａｔｉｏｎ ,ＲＦＡ)。这一类技术使用物理或化学的方法使肿瘤组织在体内发生坏死 …     

肝癌射频治疗现状

原发性肝癌是我国常见的恶性肿瘤 ,其恶性程度高 ,预后差。手术治疗作为一种有效的治疗方法 ,一直为临床医师所推崇。但由于肝癌缺乏特异性临床表现 ,且发展迅速 ,多数病人一旦确诊 ,已属中晚期 ,故手术切除率低 ,术后并发症严重 ,术后早期复发率高 ,使肝癌手术治疗受到影响〔1,2〕。作者就近年来国外新开展的射频肝癌灭活术 ,从原理、研究进展、适应证及禁忌证、影像学观察、术后并发症、疗效、预后等进行讨论。1.射频肝癌原位灭活的机理 :射频应用于软组织肿瘤切除已有多年的历史 ,近年来国外应用射频技术治疗肝癌 ,造成肝癌组织的坏死 ,…     

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自 1990年 11月至 1995年 5月 ,我们对行肝癌根治性切除术的 85例病人 ,于术中同时行肝动脉门静脉双埋泵(ＩＤＤＳ) ,用以术后化疗与栓塞 ,取得了良好的疗效。现对照同期未行埋泵术的 2 9例肝癌手术病人 ,报告如下。1　临床资料治疗组 85例 ,男 76例 ,女 9例。年龄平均 49岁 ( 2 4～73岁 )。全部病例均为肝细胞癌。单发肿瘤 75例 ,肿瘤位于肝脏某一段或有数段同时累及。多发肿瘤 ( 2处病灶 ) 10例 ,肿瘤分别位于左右肝或不相邻的两个肝段。肿瘤大小1 8～ 2 7ｃｍ不等。对照组 2 9例 ,男 2 5例 ,女 4例。年龄平均 45岁 ( 2 2～ 6 9岁 )。肿瘤…     

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??Feasibility study of parathyroid glands retained in situ during endoscopic observation MA Yun-hai*??QIAN Jun??LI Shu-ling??et al. Department of Thyroid Surgery, the First Affiliated Hospital of Kunming Medical University??Kunming 650032??China
Corresponding author??CHEN Ruo-chuan??E-mail??cruochuan@foxmail.com
Abstract Objective To observe the dynamic condition of the target parathyroid glands with intra-operative tag by endoscope across the drainage tube detained at the thyroid gland bed. Methods Fourteen patients with either unilateral thyroid benign tumor or unilateral papillary thyroid microcarcinoma performed unilateral thyroidectomy from February 2015 to June 2015 in Center of Diagnosis and Treatment of Thyroid Disease, the First Affiliated Hospital of Kunming Medical University were adopted in the study. The drainage tube was placed at the same side of the target parathyroid glands during operation. The survival and imaging data were obtained at 24 h and 48 h of post-operation under rigorously sterile condition by endoscope across drainage tube previously detained. Results By endoscope across the drainage tube??fourteen parathyroid glands including seven superior parathyroid glands and seven inferior parathyroid glands were clearly observed. In addition??thirteen and eight parathyroid glands were also observed at 24 h and 48 h of post-operation??respectively. Six of seven superior parathyroid glands were connected with macroscopic vascular pedicle??while the one which was black in colour at 24 h and 48 h of post-operation was insular and considered be thanatosis. As for six inferior parathyroid glands in situ??vascular pedicle was observed only in two of six. Furthermore??two of six inferior parathyroid glands had the symptom of faint extravasated blood while the other four were normal in colour at 24 h of post-operation. Whereafter??three inferior parathyroid glands were unable to be observed but the other three were normal in colour. Conclution It is feasible to detect the survival of parathyroid glands post-operation by endoscope across the drainage tube detained during operation.     

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??Three-dimensional endoanal ultrasound for the locational diagnosis of anal fistula: a preliminary application study BEI Shao-sheng??DING Ke, WANG Jian-xin, et al??Department of Anorectal Surgy??the Second Hospital of Shandong University??Jinan 250033??China Corresponding author??DING Ke??E-mail??dingke@163.com Abstract Objective To evaluate the effectiveness and applied value of three-dimensional (3D)-Endoanal ultrasound combined with hydrogen peroxide angiography for the locational diagnosis of anal fistula. Methods 3D-endoanal ultrasound examination was performed in 17 patients with clinically suspected anal fistulas between November 2008 and January 2009 at the Second Hospital of Shandong University and results were compared with surgical findings. Results Seventeen patients were confirmed by 3D-endoanal ultrasound examination. Nine patients had simple fistulas. Eight patients had complex fistulas. At the same time 7 patients had low located fistulas, and 10 patients had high located fistulas including 8 patients with trsphincter fistulas, 1 patient with inter sphincter fistula and 1 patient with extra-sphincter fistula. All patients were confirmed by operation. But on surgery’s professional examination 1 case with high located fistulas was remisdiagnosed as low located fistulas.3D-Endoanal ultrasound had a accuracy of 90.9%. The 3D shape and track of fistula could be well shown the site of anal fistula and its relationship with the phincter complex and the levator animuscle. Conclusion 3D-Endoanal ultrasound examination combined with fistulography is a very effective and reliable method for the locational diagnosis of anal fistula.     

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为评估原位肝移植术后早期超正常化氧输送 (ＤＯ2 Ｉ)对病人预后的影响 ,作者于 1993～ 2 0 0 0年以前瞻法对我院器官移植中心连续 31例接受原位肝移植 (ＯＬＴＸ)成年病人进行随机分组对照研究。在常规治疗的基础治疗组与对照组不同处在于治疗目标是术后第一个 2 4ｈ的ＤＯ2 Ｉ >6 0 0ｍＬ/ (ｍｉｎ·ｍ2 ) ,方法包括血制品及晶体液输入以保证有效循环血容量及保持血红蛋白浓度 >12 0ｇ/Ｌ、儿茶酚胺类和洋地黄药物的使用。对照组常规治疗。于手术后初始及12、2 4、48、72ｈ获取所有病例的氧动力学资料。所有病例随访至出院 (死亡 )。统计…     

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??Effect of glutamine on intestinal permeability and bacterial translocation in patients after abdominal surgeryJIANG Hai??ping,ZHANG Wen??bin,WANG Xi??et al.Department of General Surgery??the First Affiliated Hospital of Jinan University??Guangzhou 510630,China Corresponding author:JIANG Hai??ping,E??mail:tjhp@tom.com AbstractObjectiveThe study was conducted to examine the effects of supplemental glutamine (Gln) on intestinal permeability and bacterial translocation in patients undergone abdominal surgery.MethodsFrom May 2004 to May 2007,76 patients in the First Affiliated Hospatial of Jinan University were randomised to receive either parenteral nutrition with Gln ??n=38?? or the same nutrition alone (n=38) after abdominal surgery.Administration of Gln or parenteral nutrition alone was continued for a further 7 days and intestinal permeability was then measurerd by estimation of urine lactulose/mannito (L/M) and.intestinal??derived bacterial DNA examined by PCR after the surgery.ResultsGln in 7d after the surgery was significantly lower in control compared to patients receiving Gln.(control,532??86±107??08 μmol/L,Gln,616??14±42??13 μmol/L,P<0??01).Intestinal permeability (L/M) after the surgery was significantly lower in patients receiving Gln compared to controls,P<0??01.The incidence of bacterial positive by PCR was 10??53% (8/76) after surgery in both groups.Lower levels of Gln were detected in bacterial positive group compared to negative??P<0??05,and L/M was lower in bacterial negative group significantly compared to positive??P<0??01.ConclusionGlutamine modulates intestinal permeability and reduces bacterial translocation in patients undergoing abdominal surgery.     

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??Predictive value of procalcitonin for postoperative surgical site infection after definitive operation of intestinal fistula REN Hua-jian??LI Guan-wei??WANG Ge-fei??et al. Research Institute of General Surgery??Nanjing General Hospital of Nanjing Military Command??PLA, Nanjing 210002??China
Corresponding author??REN Jian-an??E-mail??jan@medmail.com.cn
Abstract Objective To explore the predictive value of dynamic testing procalcitonin (PCT) in postoperative surgical site infection (SSI) after definitive operation of intestinal fistula. Methods Definitive reconstruction operation of digestive tract was performed in 62 patients with intestinal fistula between February 2012 and October 2013 in Nanjing General Hospital of Nanjing Military Command. Patients with and without SSI were classified as infection group (22 cases) and normal group (40 group). PCT level??C-reactive protein level and white blood cell count were assessed preoperatively and on the 1st??3rd??5th and 7th day postoperatively. The relationship between PCT value and SSI after operation was evaluated. Results The median time when SSIs were diagnosed clinically was 6.1 days after surgery. PCT values in infection group were signi?cantly higher than those in normal group on postoperative 3rd and 5th day (P<0.05). C-reactive protein levels on postoperative 7th day in infection group were higher than those in normal group (P<0.05). White blood cell counts on postoperative 5th, 7th day in infection group were higher than those in normal group (P<0.05). Receiver-operating characteristics demonstrated that PCT had the highest diagnostic accuracy with a value more than 0.97 μg/L on postoperative 3rd day. The area under the curve (AUC) of PCT for SSI was 0.83 with 77.3% sensitivity and 87.5% specificity. In a multivariate logistic regression analysis??PCT level more than 0.97 μg/L on postoperative 3rd day was a signi?cant predictor for postoperative SSI on with an odds ratio of 27.76 (95% CI=6.17??124.90??P<0.001). Conclusion The dynamic change of PCT is valuable to predict the occurrence of SSI after definitive operation of intestinal fistula.     

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??Surgical site infection and hand-hygiene compliance LIU Song*, WANG Meng, DING Jie, et al. *Department of General Surgery, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, Nanjing 210008, China
Corresponding author??REN Jian-an??E-mail??Jiananr@gmail.com??GUAN Wen-xian??E-mail??guan_wenxian@sina.com
Abstract Objective To investigate the incidence of surgical site infection??summarize the microbial profiles and corresponding antimicrobial resistance, and analyze the correlation between the incidence of surgical site infection and the consumption of hand-hygiene products. Methods The clinical data of all patients that received surgical procedures in 2015 in Nanjing Drum Tower Hospital and the General Hospital of Nanjing Military Command were collected retrospectively. The characteristics of surgical site infection were analyzed. Spearman correlation and multiple linear regression models were performed for correlation analysis. Results A total of 30 678 surgical procedures were performed in 2015. Among them??307 cases of surgical site infection were identified with an overall incidence of 1.00%. General Surgery and Neurosurgery exhibited the highest and lowest incidence of surgical site infection?? with 2.14% and 0.14% respectively. E. coli ??35.8%????S. aureus ??13.2%????E. faecalis ??7.84%????P. aeruginosa ??5.89%?? and K. pneumoniae ??4.90%?? were the most common pathogens of surgical site infection. Antimicrobial resistance profiles varied between different types of pathogens. A significant negative correlation was identified between consumption of hand-hygiene products and incidence of surgical site infection ??r=-0.83~-0.88??P=0.0031~0.0083??. Furthermore?? the consumption of hand sanitizer could significantly impact the incidence of surgical site infection among surgical patients ??P=0.023??. Conclusion Hand hygiene is involved in the occurrence of surgical site infection. Promoting hand-hygiene compliance could probably decrease the incidence of surgical site infection. The characteristics of surgical site infection in current study could assist to tailor regional antimicrobial strategy in China.     

131I-LPD内辐射治疗原发性肝癌的研究

目的研究131I－LPD选择性内辐射治疗原发性肝癌的吸收剂量及其疗效。方法对8例经手术证实不能切除的肝癌患者经肝动脉反复灌注131I－LPD计算癌组织的吸收剂量,观察其疗效。结果8例平均接受了25次内辐射治疗,放射性活废为（529±127）MBq.131主要聚集在肝癌病灶,癌肝放射性计数比值（T／NT）为2．50～8．50（SD5．60±1．78）。癌组织接受的内辐射吸收剂量为（1792±774）cGY。8例中有5例AFP＞500μg／L,,治疗后转为正常。其中4例因癌肿缩小得以再切除。8例的3年生存率为74％,5年生存率为56％。结论131I－LPD经肝动脉灌注是较理想的内辐射治疗肝癌的方法。     

腹腔镜辅助射频消融与经皮射频消融治疗原发性肝癌的临床对照研究

目的 回顾性研究腹腔镜辅助射频消融(laparoscopic radio frequency ablation,LRFA)与经皮射频消融( percutaneous radio frequency ablation,PRFA)治疗原发性肝癌(hepatocellular carcinoma,HCC)和特殊部位HCC的安全性和疗效.方法 回顾性分析525例HCC患者671个肿瘤结节,其中LRFA组78例106个肿瘤结节,PRFA组447例565个肿瘤结节.结果 (1)术后瘤体完全消融率:LRFA组为97.17％ (103/106),PRFA组为93.09％ (526/565).2组的瘤体完全消融率比较差异无统计学意义(x2=2.523,P =0.112).(2)1、3、5年总生存率:LRFA组为96.15％、55.12％和38.46％,PRFA组为93.73％、48.54％和31.54％.1、3、5年无瘤生存率:LRFA组为94.87％、43.58％和28.21％,PRFA组为91.65％、40.27％和25.95％.平均无瘤生存时间:LRFA组为22.25个月,PRFA组为21.53个月.2组1、3、5年总生存率比较差异无统计学意义(分别x2=0.699,1.151,1.447,P=0.403,0.283,0.229),无瘤生存率比较差异无统计学意义(分别x2=0.915,0.303,0.174;P =0.339,0.582,0.676).(3)严重并发症发生率LRFA组为0％ (0/78),PRFA组为1.34％( 6/447).(4) LRFA组复发率23.07％(18/78),复发时间为4～32个月;PRFA绢复发率34.89％(156/447),复发时间为3 ～38个月.2组复发率比较差异有统计学意义(x2=4.189,P=0.041).结论 LRFA的总体治疗效果等同于PRFA,但是LRFA的复发率和严重并发症的发生率较低,安全性较高.     

肝细胞肝癌切除后复发（欧洲经验）

目的 探讨肝细胞肝癌切除后复发的预后相关因素及合理治疗方法。方法 １９８３年１月至１９９７年１月２７１例肝癌切除后有１３４例复发,对其一般情况,肿瘤特性及外科措施进行多因素分析,同时比较复发后不同治疗方法的结果。结果 复发时间在术后１年内,首次手术时ＡＦＰ〉１０００μｇ／Ｌ肿瘤直径〉５ｃｍ,门静脉有癌栓,外科切缘为０及术前行肝动脉插管化疗者等６大因素直接影响复发的预后,同时发现,复发肿瘤可行再次切     

Current status of radio-frequency ablation for hepatocellular carcinoma

Summary BACKGROUND: Radio-frequency ablation (RFA) is the latest developed and widely practised local ablation therapy for liver tumours. It has the merit of effective tumour ablation and preservation of the maximal normal liver parenchyma. In the past few years, there has been tremendous expansion in the application of RFA for hepatocellular carcinoma (HCC) patients. However, the therapeutic effect of this local-ablation treatment needs to be balanced against its risks and possible local failure. METHODS: This review focuses on the current status of RFA for HCC, with attention to its indications, approaches, risks, local failure, and survival benefit. RESULTS: Although the results of most clinical studies of RFA seem optimistic, the associated complication and tumour recurrence should not be overlooked. Careful patient selection, meticulous RFA techniques, and prompt treatment of residual and recurrent tumours are necessary to ensure a better outcome after RFA. CONCLUSIONS: Until recently, there has been no strong evidence showing that RFA can replace any treatment modalities in the management of HCC. Nonetheless, more convincing evidence by randomised trials is required for the establishment of a treatment protocol of RFA for HCC patients.      

腹腔镜下射频消融治疗肝癌破裂出血的临床研究

目的:探讨腹腔镜下射频消融(LRFA)治疗原发性肝癌破裂出血的临床价值.方法:选取我院2007年7月-2011年7月确诊为肝癌破裂出血患者49例,其中男30例,女19例;年龄45 ～ 76岁,中位年龄(56.0±5.1)岁;LRFA治疗组(LRFA组)16例,手术切除治疗组(对照组)33例;统计分析两组患者性别、年龄、术前肝功能分级、术中肝门阻断时间、术中出血量、手术时间、止血成功率、术后并发症发生率、再出血率的差异、生存时间及生存率的差异,检验LRFA临床效果.结果:两组患者在性别、年龄、术前肝功能分级、肿瘤大小、数目方面的差异无统计学意义(P＞0.05);而两组患者在肝门阻断时间、术中出血量、手术时间、止血情况、再出血情况、术后并发症发生率及术后1年生存率差异有统计学意义(P＜0.05).结论:LRFA是肝癌破裂出血安全、可靠、有效的治疗手段,或可成为急诊肝癌破裂出血的首选方法.     

Intrahepatic dissemination of hepatocellular carcinoma after local ablation therapy

Background/Purpose  We aimed to clarify the histological features of and risk factors for intrahepatic dissemination after local ablation therapy (LAT) for hepatocellular carcinoma (HCC). Methods  Between April 1992 and December 2005, 192 HCC patients underwent hepatic resection at our department, among whom were 17 patients who had local recurrences after LAT. Eight of these 17 patients had intrahepatic dissemination. The clinical and histological characteristics of these 8 surgically treated patients with intrahepatic dissemination were investigated. Results  Histologically, numerous intrahepatic metastases were observed, mainly in the same section as the treated tumor, together with main or sectional portal vein tumor thrombi. Before the ablation therapy, the average tumor diameter was 2.1 cm, and 62.5% of the tumors were adjacent to the main or sectional portal vein. In terms of therapeutic factors, 25% of the patients had a prior needle biopsy and 62.5% had insufficient safety margins. Conclusions  LAT for HCCs (even those less than 3 cm in diameter) adjacent less than 5 mm to the main or sectional portal vein possibly promotes intrahepatic dissemination.     

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目的　评估经皮热消融对不能再手术切除的复发性肝细胞癌 (RHCC)的临床治疗价值。方法　 1997年 10月至 2 0 0 2年 12月中山大学附属第一医院采用超声引导经皮射频消融 (RFA)或微波消融 (MWA)治疗不能再手术切除的RHCC ,35例共 87个肿瘤结节 ,直径 0 9～ 6 4cm。观察局部疗效、治疗并发症和远期生存情况。结果　肿瘤完全消融率 (完全灭活率 )为 97 7% (85 / 87) ,其中直径≤ 3cm结节为 98 6 %、3cm以上者为 94 1%。无治疗死亡 ,并发症发生率为 2 9% (1/ 35 )。平均随访 (2 7 7± 16 7)个月 ,肿瘤局部复发率为 10 6 % (9/ 85 ) ;远处复发率为 91 4 % (32 / 35 ) ,其中 15例 (4 7% )发生多次远处复发。经对局部复发和远处复发者的反复治疗 ,首次消融后 1、3、5年累积生存率分别为 77 1%、4 6 2 %和 14 9% ,中位生存期为 2 5 2个月 ;首次肝切除后 1、3、5及 10年生存率分别达到 96 2 %、6 4 1%、4 7 7%和 14 1% ,中位生存期为 5 7 0个月。结论　经皮热消融技术局部灭瘤效果满意 ,创伤微小且便于反复施行 ,能够显著改善病人的远期生存 ,是不能再切除的RHCC有效治疗手段。     

腹腔镜辅助下原发性肝癌和肝转移癌的射频消融术治疗

目的 :探讨腹腔镜辅助下肝癌射频消融术治疗的优势。方法 :全麻下联合腹腔镜技术对原发性肝癌和多发的肝转移癌灶行射频消融术治疗。结果 :1 0例患者 32个瘤体 ,其中直径 5cm的 2 0个瘤体均一次手术热凝损毁 ,CT和MRI提示肿瘤坏死 ,其中 ,1 5个瘤体完全缓解 (CR)占 75 % ,5个瘤体部分缓解 (PR)占2 5 % ,近期疗效CR +PR为 1 0 0 %。随访 2～ 1 4个月无复发。直径 >5cm的 1 2个瘤体亦予以一次性热凝损毁 ,术后 1～ 8周内AFP、CEA、CA1 9 9肿瘤指标均转阴或下降 ,CT或MRI提示肿瘤热凝损毁 ,近期疗效CR +PR为 83 3%。患者均能耐受射频消融治疗 ,无并发症发生。 1例原发性肝癌术后 1 3个月死于肿瘤扩散。结论 :腹腔镜辅助下肝癌射频消融术治疗直径 5cm的瘤体效果显著 ,对直径 >5cm的瘤体部分有效。此法为腹腔镜辅助下结直肠癌手术中多发肝转移癌灶的处理提供了一种创伤小、时间短、见效快、安全方便的治疗方法。     

以阻塞性黄疸为首发症状的肝癌手术治疗

目的 探讨以阻塞性黄疸为首发症状的肝癌病人的临床特征及治疗方法。方法 收集原发性肝癌侵犯胆管病人39例,对其临床特征及诊断、治疗方法进行了分析。结果 此类患者占肝癌病人的比例为6．3％,全部病人均进行了手术治疗。B型超声及CT检查的阳性率分别为88．2％和80．0％,合并门静脉癌栓者为48．7％。结论 本病的主要诊断依据为影像学检查结果,主要手术方式为肝叶切除及胆管引流。     

Radio Frequency Ablation for Hepatocellular Carcinoma in Cirrhotic Patients: Prognostic Factors for Survival

Background  Radio frequency ablation (RFA) of hepatocellular carcinoma has proved to be useful in local control of tumor. A few data on survival after treatment are available in literature. The aim of the study was to evaluate factors related to survival and to identify different classes of risk after radio frequency ablation. Methods  Ninety-eight cirrhotic patients with 145 hepatocellular carcinomas were treated with radio frequency ablation from January 1998 to May 2004. In 55 patients, cirrhosis was in Child-Pugh class A, and in 43, in class B. Tumor was single in 60 and multiple in 38; mean tumor number was 1.5 (range 1–3). Tumor size ranged from 1.5 to 6.0 cm, mean 3.8 cm. Mean follow up period was 24.9 months. Radio frequency ablation was performed with expandable type needle with percutaneous approach under real-time ultrasound guidance. For statistical analysis, univariate and multivariate analysis were performed. Results  Complete ablation of the tumor was achieved in 85.5% of lesions. Survival, 1 and 3 years, was 76.7 and 36.6%, respectively. Univariate analysis showed that Cancer of the Liver Italian Program (CLIP) score, tumor growth pattern, α-fetoprotein level, and complete tumor necrosis, were factors significantly related to poor survival. Multivariate analysis identified that factors related to poor survival were α-fetoprotein level >100 ng/ml, Child-Pugh class B, and incomplete tumor necrosis with a hazard ratio of 4.0, 2.7, and 3.8, respectively. After complete ablation, median survival was 38 months in patients with Child-Pugh class A cirrhosis and α-fetoprotein level ≤100 ng/ml, 22 months for patient with Child-Pugh class B cirrhosis and α-fetoprotein ≤100 ng/ml, and 9 months for patient with Child-Pugh class A cirrhosis and α-fetoprotein >100 ng/ml (P < 0.01). Conclusions  Complete necrosis and absence of residual tumor positively affect survival after RFA. In patients with Child-Pugh A cirrhosis and α-fetoprotein level ≤100 radio frequency, ablation have results, 55% after 3 years, that are comparable to those of surgical resection. Patients with Child-Pugh B cirrhosis and/or α-fetoprotein >100 ng/ml showed less satisfactory results, and in these patients, multimodality treatment or other treatments should be considered.