射频消融治疗单发小肝癌的疗效与安全性

目的探讨射频消融（RFA）治疗单发小肝癌的疗效与安全性。方法回顾性分析2008年1月至2010年6月在江西省人民医院接受治疗的67例单发小肝癌患者的临床资料。67例患者按治疗方法分为射频消融组（n=32）和手术切除组（n=35）,比较2组患者的近期疗效、生存率、复发率和治疗后并发症。结果射频消融组3年生存率为75.0%,其中肿瘤直径〈3cm患者的3年生存率为78.2%,3～5cm的患者3年生存率为72.2%,二者相比差异有统计学意义（P〈0.05）;治疗后1、2和3年复发率分别为15.6%、28.7%和37.5%;治疗后并发症发生率为8.6%。手术切除组患者术后3年生存率为74.3%,其中肿瘤直径〈3cm患者3年生存率为75.0%,3～5cm患者的3年生存率为73.7%,二者相比差异无统计学意义（P〉0.05）;术后1、2和3年复发率分别为17.1%、28.6%和40.0%,治疗后并发症发生率为31.2%。2组术后1、2、3年复发率相比,差异无统计学意义（P〉0.05）;治疗后并发症发生率射频消融组显著低于手术切除组,差异有统计学意义（P〈0.05）。结论射频消融与手术切除治疗单发小肝癌患者的疗效相当,射频消融治疗较传统手术相比具有微创、安全、可重复性的优点。

Effect and Safety of Radiofrequency Catheter Ablation for Single Small Hepatocellular Carcinoma

Objective To evaluate the effect and safety of radiofrequency catheter ablation in the treatment of single small hepatocellular carcinoma（HCC）.Methods Clinical data of 67 small HCC patients treated in Jiangxi provincial people＇s hospital between January 2008 and June 2010 were retrospectively analyzed.These patients were divided into radiofrequency ablation group（n=32） and surgical excision group（n=35）.The short-term effect,survival rate,recurrence rate and complications were compared between the two groups.Results In radiofrequency ablation group,the 3-year survival rate was 75.0% and complication rate was 8.6%.The differences in 3-year survival rate were statistically different between patients with tumor size3 cm and patients with tumor size 3~5 cm（78.2% vs 72.2%,P0.05）.At 1,2 and 3 years after treatment,recurrence rate was 15.6%,28.7% and 37.5%,respectively.In surgical excision group,the 3-year survival rate was 74.3% and complication rate was 31.2%.The differences in 3-year survival rate were not statistically different between patients with tumor size3 cm and patients with tumor size 3 ~ 5 cm（75.0% vs 73.7%,P0.05）.At 1,2 and 3 years after treatment,recurrence rate was 17.1%,28.6% and40.0%,respectively.There were no significant differences in 3-year survival rate and recurrence rate between the two groups（P0.05）,while complication rate in radiofrequency ablation group was obviously lower than that in surgical excision group（P0.05）.Conclusion Radiofrequency catheter ablation and surgical resection have equivalent effects on small HCC.But,radiofrequency catheter ablation has the advantages of minimal invasion,safety and repeatability compared with the traditional surgery.