射频消融与手术切除治疗直径3~5 cm肝癌的倾向性评分匹配研究

目的:比较射频消融（RFA）与手术切除治疗直径3~5 cm肝癌的临床疗效和预后。方法:选取2014年1月至2016年12月我院收治的124例肝癌患者，其中行手术切除者64例（手术组），行RFA治疗60例（射频组），运用倾向性评分匹配，得到组间一般资料均衡的样本，对新样本进行并发症、住院时间和预后的比较。结果:两组患者共42对匹配。两组患者均未出现围手术期死亡病例。手术组术后总并发症的发生率和住院时间高于对照组，差异均有统计学意义（P＜0.05）。手术组1年、2年和3年的总生存率为92.9%、73.8%和60.2%，射频组1年、2年和3年的总生存率为95.2%、75.9%和55.0%，两组比较差异无统计学意义（P=0.931）。手术组1年、2年和3年的无瘤生存率为71.4%、50.0%和34.7%，射频组1年、2年和3年的无瘤生存率为73.8%、50.0%和32.1%，两组比较差异无统计学意义（P=0.907）。结论:对于直径3~5 cm肝癌患者而言，RFA与手术切除疗效相当，且RFA创伤更小、并发症少、恢复更快。

Propensity score matching of radiofrequency ablation and surgical resection for hepatocellular carcinoma with diameter of 3~5 cm

Objective:To compare the clinical efficacy and prognosis of radiofrequency ablation(RFA)and surgical resection for hepatocellular carcinoma with a diameter of 3 to 5 cm.Methods:From January 2014 to December 2016,124 patients with hepatocellular carcinoma were selected.Among them,64 underwent surgical resection(operation group)and 60 underwent RFA treatment(radio frequency group).Using propensity score matching,a sample with balanced balanced general data was obtained,and the incidence of complications,hospitalization time and prognosis of the new sample were compared.Results:There were 42 matches between the two groups.There were no perioperative deaths in both groups.The incidence of total complications and hospitalization time in the operation group were significantly higher than those in the control group(P<0.05).The overall survival rates for 1,2 and 3 years in the operation group were 92.9%,73.8%and 60.2%,while those for 1,2 and 3 years in the radio frequency group were 95.2%,75.9%and 55.0%.The 1-year,2-year and 3-year disease-free survival rates were 71.4%,50.0%and 34.7%in the operation group and 73.8%,50.0%and 32.1%in the radio frequency group,respectively.The differences in the overall survival rate and disease-free survival rate between the two groups were not statistical significant(P=0.931,0.907).Conclusion:For patients with hepatocellular carcinoma with a diameter of 3~5 cm,RFA has the same effect as surgical resection,and RFA has less trauma,fewer complications and faster recovery.