手术切除与射频消融针对中等大小肿瘤疗效分析

目的：探讨两种不同治疗方法针对单发肿瘤直径介于3～6 cm的肝癌疗效，为临床治疗方式的选择提供依据。方法回顾性分析2008年12月至2011年12月期间在第三军医大学西南医院全军肝胆外科研究所接受手术切除或射频消融治疗单发肿瘤直径介于3～6 cm肝癌的近、远期疗效，比较两种手术方式的疗效差异。结果手术组术后1年以内复发41例，复发率为32．5％，2年以内复发87例，复发率为69．1％，3年以内复发103例，复发率为81．7％，射频消融组术后1年内复发29例，复发率为40．8％，2年以内复发51例，复发率为71．8％，3年以内复发60例，复发率为84．5％，二者之间同时间段复发率差异有统计学意义（ P＝0．039）；手术组存活率第1、2、3年内分别为84．6％，69．8％，56．3％，射频消融组存活率第1、2、3年内分别为85．3％，70．9％，53．4％，二者同时间段存活率差异无统计学意义（ P＝0．105）。结论针对大小介于3～6 cm的单发性肝癌，射频消融治疗可作为首选治疗方法。

The efficacy of surgical resection or radiofrequency ablation in treatment of medium-sized tumor

Objective To investigate the efficacy of two different methods in treatment of liver cancer which sizes ranged from 3 to 6cm ,and provide the basis for clinical treatment methods .Methods A retrospective analysis of the curative effect of liver cancer patients whose tumor diameter were rang from 3 to 6 cm was done .All patients collected from the Forth Cadre′s Sanatorium and Health Center ,Military Region in Shandong province Taian zones at the time of December 2008 to December 2011 who carried out surgical resection or radiofrequency ablation .Results 41 cases of recurrence within a year in surgical group ,the recurrence rate was 32 .5% ,87 cases(69 .1% ) of recurrence ,103 cases(81 .7% ) of recurrence within 3 years ;41 cases of recurrence within a year in radio frequency ablation group ,the recurrence rate was 40 .8% ,51 cases(71 .8% ) of recurrence within 2 years ,60 cases(84 .5% ) of recurrence within 3 years ,a statistically significant difference were found between the two group at the same period time (P<0 .05);1 ,2 ,3 year survival rates were 84 .6% ,69 .8% ,56 .3% in surgical group ,radiofrequency 1 ,2 ,3 year survival rates were 85 .3% ,70 .9% ,53 .4 in radio frequency ablation group ,The difference was not statistically significant at the same period time (P>0 .05) .Conclusion For size between 3 to 6 cm liver cancer ,radiofrequency ablation can be used as the preferred method of treatment .