早期复发肝细胞癌的手术切除与射频消融

StephenW

早期复发肝细胞癌的手术切除与射频消融

石通通加；徐成辉；冯月敏；魏英南；吕焕然；朱强c,a
作者信息

a山东省立医院消化内科，山东大学齐鲁医学院

b山东第一医科大学附属山东省立医院消化内科，济南

c新疆医科大学第一附属医院消化内科，乌鲁木齐

2022 年 4 月 7 日收到 2022 年 5 月 4 日接受

中国乌鲁木齐市乌鲁木齐市尚德北路567号新疆医科大学第一附属医院消化内科朱强医学博士 830017 联系电话：+86 531 68777012；邮箱：[email protected]
欧洲胃肠病学和肝病学杂志：2022 年 8 月 - 第 34 卷 - 第 8 期 - 第 844-851 页
doi: 10.1097/MEG.0000000000002393

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抽象的
背景

手术切除（SR）和射频消融（RFA）是早期复发性肝细胞癌（rHCC）的合理治疗选择，但尚不确定哪种治疗更好。本研究的目的是比较 SR 和 RFA 对早期 rHCC 患者的治疗效果。
方法

该研究招募了 168 名接受 SR 或 RFA 的早期 rHCC 患者。比较了总和倾向评分匹配 (PSM) 队列的治疗组之间的无进展生存期 (PFS)、总生存期 (OS) 和并发症。
结果

在 PSM 之前，1 年、3 年、5 年 OS（94.8%、63.0%、36.1% 对比 93.8%、58.5%、35.4%，P = 0.580）和 PFS（50.7%、22.7%、12.0% 对比. 68.8%、30.3%、15.9%，P = 0.224）在 RFA 组和 SR 组中相似。 PSM 后，1 年、3 年、5 年 OS（95.5%、71.1%、53.3% 对 95.5%、58.0%、42.1%，P = 0.285）和 PFS（50%、36.4%、27.3% 对. 68.2%、25.6%、12.8%，P = 0.999）在 RFA 组和 SR 组中相似。对于早期复发肿瘤≤3 cm的患者，RFA和SR可以达到相似的疗效。然而，对于早期复发肿瘤>3 cm的患者，SR在PFS方面优于RFA，但OS相似。对于所有患者，与 SR 相比，RFA 的并发症明显更少，住院时间更短。
结论

对于 SR 后早期 rHCC（>3 cm）的患者，与 RFA 相比，SR 实现了更好的肿瘤控制。与所有患者的 SR 相比，RFA 的并发症明显更少，住院时间更短。
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StephenW

Surgical resection versus radiofrequency ablation for early recurrent hepatocellular carcinoma

Shi, Tongtonga; Xu, Chenghuia; Feng, Yueminb; Wei, Yingnanb; Lv, Huanranb; Zhu, Qiangc,a
Author Information

aDepartment of Gastroenterology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University

bDepartment of Gastroenterology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan

cDepartment of Gastroenterology, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, China

Received 7 April 2022 Accepted 4 May 2022

Correspondence to Qiang Zhu, MD, Department of Gastroenterology, The First Affiliated Hospital of Xinjiang Medical University, 567#, Shangde North Road, Urumqi 830017, Urumqi, China, Tel: +86 531 68777012; e-mail: [email protected]
European Journal of Gastroenterology & Hepatology: August 2022 - Volume 34 - Issue 8 - p 844-851
doi: 10.1097/MEG.0000000000002393

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Abstract
Background

Surgical resection (SR) and radiofrequency ablation (RFA) are reasonable treatment options for early recurrent hepatocellular carcinoma (rHCC), but it is still uncertain which treatment is better. The purpose of this study was to compare the therapeutic effects of SR and RFA on patients with early rHCC.
Methods

This study enrolled 168 patients with early rHCC who underwent SR or RFA. The progression-free survival (PFS), overall survival (OS), and complications between the treatment groups for the total and propensity score-matched (PSM) cohorts were compared.
Results

Before PSM, the 1-, 3-, 5-year OS (94.8%, 63.0%, 36.1% vs. 93.8%, 58.5%, 35.4%, P = 0.580) and PFS (50.7%, 22.7%, 12.0% vs. 68.8%, 30.3%, 15.9%, P = 0.224) were similar in RFA group and the SR group. After PSM, the 1-, 3-, 5-year OS (95.5%, 71.1%, 53.3% vs. 95.5%, 58.0%, 42.1%, P = 0.285) and PFS (50%, 36.4%, 27.3% vs. 68.2%, 25.6%, 12.8%, P = 0.999) were similar in the RFA group and the SR group. For patients with early recurrent tumors ≤3 cm, RFA and SR could achieve similar curative effects. However, SR was superior to RFA in terms PFS for patients with early recurrent tumors >3 cm, but the OS was similar. For all patients, RFA had significantly fewer complications and shorter hospitalization time compared with SR.
Conclusion

SR achieves better tumor control compared with RFA for patients with early rHCC (>3 cm) after SR. RFA had significantly fewer complications and shorter hospitalization time compared with SR for all patients.
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