小肝癌手术切除后复发的可能性有多大？

liver_GZ

回复 sophewave 的帖子

小肝癌的治疗，在学界应该是没有太大疑议的。

那就是，
1）只要肝功能、身体等条件允许，手术切除是首选。
2）局部消融措施，亦可选。主要针对直径<3cm的肝癌，一般而言，中期疗效匹配手术切除。但从近年发表的长期随访文献来看，射频消融对小肝癌，仍稍弱于肝切除。
3）对于<3CM的小肝癌，射频消融联合TACE，并不优于单独的射频消融术。
Radiology. 2009 Sep;252(3):905-13. Epub 2009 Jun 30.
Small hepatocellular carcinoma: is radiofrequency ablation combined with transcatheter arterial chemoembolization more effective than radiofrequency ablation alone for treatment?Shibata T, Isoda H, Hirokawa Y, Arizono S, Shimada K, Togashi K.
SourceDepartment of Radiology, Kyoto University Graduate School of Medicine, 54-Kawaharacho, Shogoin, Sakyoku, Kyoto 606-8507, Japan. [email protected]

AbstractPURPOSE: To prospectively compare combined radiofrequency ablation and transcatheter arterial chemoembolization (TACE) with radiofrequency ablation alone for the treatment of small (< or =3 cm) hepatocellular carcinomas (HCCs).
MATERIALS AND METHODS: The ethics committee of the study institution approved the study protocol. Written informed consent was obtained from all patients at enrollment. Eighty-nine patients with 93 HCC nodules 0.8-3.0 cm (mean +/- standard deviation, 1.7 cm +/- 0.5) in diameter were randomly treated with combined radiofrequency ablation and TACE (46 patients with 49 nodules) or with radiofrequency ablation alone (43 patients with 44 nodules). The patients were followed up for 9-68 months (mean +/- standard deviation, 30.4 months +/- 14.0). Rates of local tumor progression, overall survival, local progression-free survival, and event-free survival were evaluated by using the Kaplan-Meier method.
RESULTS: The 1-, 2-, 3-, and 4-year rates of local tumor progression, overall survival, local progression-free survival, and recurrence-free survival were as follows: Local tumor progression rates were 14.4%, 17.6%, 17.6%, and 17.6%, respectively, in the combined treatment group and 11.4%, 14.4%, 14.4%, and 14.4%, respectively, in the radiofrequency ablation group (P = .797). Overall survival rates were 100%, 100%, 84.8%, and 72.7%, respectively, in the combined treatment group and 100%, 88.8%, 84.5%, and 74.0%, respectively, in the radiofrequency ablation group (P = .515). Local progression-free survival rates were 84.6%, 81.1%, 69.7%, and 55.8%, respectively, in the combined treatment group and 88.4%, 74.1%, 74.1%, and 61.7%, respectively, in the radiofrequency ablation group (P = .934). Event-free survival rates were 71.3%, 59.9%, 48.8%, and 36.6%, respectively, in the combined treatment group and 74.3%, 52.4%, 29.7%, and 29.7%, respectively, in the radiofrequency ablation group (P = .365).
CONCLUSION: Combined radiofrequency ablation plus TACE and radiofrequency ablation alone have equivalent effectiveness for the treatment of small (< or =3 cm) HCCs, so the combination treatment may not be necessary.

Comment in

• Radiology. 2010 Feb;254(2):633; author reply 634.
  

PMID:19567647

骗中骗

你的同事以前是否有不良的生活习惯？
熬夜、喝酒、饮食不注意、长期劳累、精神压力大、性格追求完美。。。
发病前是否有以下症状：
1.肝区疼痛
2.乏力
3.耳垢增多。
4.膝关节、肘关节疼痛。
5.脸上突然长青春豆
6.肩膀痛。
7.手臂上长黑疣。

干干净净13

回复 骗中骗 的帖子

谢谢各位的热心答复！朋友没有不良嗜好和明显症状，例行检查查出来的。

sophewave

回复 liver_GZ 的帖子

终于等到411老师了，感谢。
我爸爸昨天做完了第一次介入。结果出人意料。
主治医生说打了两次造影剂都未显示将肿瘤包起来，医生最后还是继续介入，说是等一个月后再复查做MRI，看看肿瘤周围是否有有留包围，他说的专业，我听起来就是这个意思。
我就奇怪了，当时在小市医院做的B超+增强CT+造影均为考虑肝CA。
后来，因是单发小肝，我们晚辈反复考量，决定用保守的方法先做介入。于是选择了一家大市医院进行了昨天的介入手术。
结果就出现了以上情况。
请教411老师，您看问题出在哪里。
昨天的结果让晚辈几个都喜出望外，可是我现在都不敢放松警惕了。

liver_GZ

回复 sophewave 的帖子

1、请不要在其他战友帖子 发帖里提问。
建议自己新开帖。

2、我提供的治疗意见非常明确了。
不再复述。

3、我不是411老师。

good-luck

RichardTu 发表于 2011-6-9 01:20
小肝癌根治性切除后五年存活率可以达到70％多，但是千万记得定期（每三个月）到手术医院随访。
另，坚持服 ...

那么5年后的存活率呢？是否有可能不再复发？

橙子红也

good-luck 发表于 2011-6-11 10:49
那么5年后的存活率呢？是否有可能不再复发？

这个问题不好回答的，把心态、饮食、睡眠调整好，术后评估是否需抗病毒能延缓病情恶化！

苦烟云

复发很正常，不复发才是幸运

sophewave

回复 liver_GZ 的帖子

sorry.

xiaokeyizu

包膜完整的小HCC的复发率很低!