射频消融与手术切除治疗原发性中小肝癌的疗效比较

目的:比较射频消融术与开腹手术切除治疗直径≤5 cm的原发性肝癌的临床疗效.方法:回顾性分析原发性中小肝癌患者233例,其中资料完整者119例,分为行射频治疗者(射频组)57例和行手术治疗者(手术组)62例,分析2组临床疗效.结果:射频组术后1、3、5年总体生存率为91.2%、63.2%、56.1%,术后1、3、5年无瘤生存率为82.5%、35.1%、21.1%;手术组术后1、3、5年总体生存率为91.9%、64.5%、59.7%,术后1、3、5年无瘤生存率分别为83.9%、45.2%、25.8%,2组患者生存时间差异无统计学意义(P>0.05).射频组术后住院时间及医疗费用均明显少于手术组(P<0.01).结论:原发性中小肝癌采用射频消融术与手术切除具有相近的治疗效果,射频消融术创伤小、操作方便、术后并发症少、花费更低,在治疗中小肝癌上有望替代开腹手术.

Comparison of the clinical effect between radiofrequency ablation and laparotomy in the treatment small primary liver carcinoma

Objective:To investigate the clinical effects of the radiofrequency ablation and laparotomy in treatment primary liver cancer(diameter≤5 cm). Methods:The clinical data of 233 patients with primary liver cancer were retrospectively analyzed. One hundred and ninteen tumors with diameter≤5 cm were treated with radiofrequency ablation ( radiofrequency group, 57 cases ) and laparotomy(operation group,62 cases),respectively. The clinical curative effects between two groups were compared. Results:The postoperative 1,3 and 5-years overall survival rates in radiofrequency group were 91. 2%,63. 2% and 56. 1%,respectively. The postoperative 1,3 and 5-years disease-free survival rates in radiofrequency group were 82. 5%,35. 1% and 21. 1%,respectively. The postoperative 1,3 and 5-years overall survival rates in operation group were 91. 9%,64. 5% and 59. 7%,respectively. The postoperative 1,3 and 5-years disease-free survival rates in operation group were 83. 9%,45. 2% and 25. 8%,respectively. The difference of the survival time between two groups was not statistically significant(P>0. 05). The hospitalization time and cost in radiofrequency group were significantly less than those in operation group(P<0. 01). Conclusions:The clinical curative effect of the radiofrequency ablation is similar to the laparotomy. The tretament of primary liver cancer with radiofrequency ablation is less trauma,easy,less postoperative complication and lower cost,which can replace laparotomy.