原发性肝癌术后复发再手术切除与射频消融治疗的疗效比较

目的 探讨原发性肝癌切除术后复发行射频消融治疗（RFA）与再次手术切除之间疗效差别.方法 对确诊为原发性肝癌行肝癌根治性切除术后有肝内复发而无肝外转移的患者168例,行RFA治疗者99例,行再手术治疗者69例,不包括肝功能为Child C级的患者.RFA组中肿瘤最大直径为4.5cm,平均2.1cm;再手术组中肿瘤最大直径为5.5cm,平均3.5cm.比较两组治疗效果.结果 RFA组均未出现严重并发症,而再手术组中1例死于术后肝功能衰竭.RFA组和再手术组的1、2和3年生存率分别为73.7％（73/99例）、61.6％（61/99例）、53.6％（22/41例）和68.2％（47/69例）、56.5％（39/69例）、45.4％（10/22例）,组间差异无统计学意义（P＞0.05）.结论 RFA组与再手术组相比,预后及疗效相近,但射频治疗适应证更宽,术后出现肝功能衰竭的几率更低,术后肝功能损害恢复更快.

Compare of the efficacy between re-operation and radiofrequency ablation on postoperative recurrent carcinoma

Objective To investigate the efficacy of radiofrequency ablation （RFA） comparing to operation in the treatment of postoperative recurrent hepatocellular carcinoma （RHCC）.Methods 168 post radical operation patients with recurrent hepatocellular carcinoma were retrospectively analyzed,excluding those with extrahepatic metastasis or Child C liver function.Of those patients,99 cases were treated with RFA therapy,while the other 69 cases were applied with recurrency excision.In RFA treated group,the average size of recurrent lesions was 2.1cm in diameter,in which the maximal size of tumor was 4.5cm in diameter.In the re-operation group,the average size of recurrent lesions was 3.5cm in diameter,in which the maximal size of tumor was 5.5cm in diameter.Results No severe complications were observed in RFA group,while 1 case was succumb to hepatic failure in re-operation group.No significance of 1-year,2-year and 3 -year survival rate was observed （P〈0.05） between RFA group and Re-operation group,in which the 1-year,2-year and 3-year survival rate were 73.7% （73/99）,61.6% （61/99）,53.6% （22/41） of RFA group,comparing to 56.5%（39/69）,45.4% （10/22）,45.4% （10/22） of re-operaion group,respectively.Conclusion There was no difference of therapeutic effect between RFA group and re-operation group,as well as prognosis,in RHCC patients.RFA treatment could acquire less incidence of hepatic failure and better recovery of hepatic function,with wider range of application.