摘要
目的观察射频消融(RFA)治疗肝癌肝移植术后肿瘤肝内复发的疗效和并发症,并探讨影响其预后的因素。方法 26例术后肝内复发且接受RFA治疗者为RFA组。24例未使用抗肿瘤治疗者为对照组。观察生存情况、AFP、并发症及不良反应等情况,并分析RFA术预后的影响因素。结果两组患者基线之间差异无显著性(P>0.05)。RFA组中位生存时间较对照组明显延长(P<0.01)。对照组入组1月AFP明显增加(P<0.05);而RFA组AFP较前明显降低(P<0.05)。常见近期并发症为肝包膜下出血(8/26);常见不良反应为发热(24/26)、疼痛(26/26)及胃肠道症状(11/26)。RFA组术后复发率为81%(21/26)。肿瘤数目、最大直径、门静脉癌栓及肝移植术后近期复发等因素,均是肝移植术后肿瘤肝内复发经RFA治疗后肿瘤复发的危险因素(P<0.05)。结论 RFA治疗对肝移植术后肝癌复发可以获得较好的疗效,而且并发症少、患者耐受良好。
【Objective】 To investigate the effects,complications and the prognostic factors of the radio-frequency ablation（RFA） in the treatment of intrahepatic recurrence following liver transplantation for hepatocellular carcinoma（HCC）.【Methods】 The group of 26 patients who received RFA for intrahepatic recurrence following liver transplantation for HCC were allocated to RFA group.The other group of 24 patients who did not receive anti-tumor treatment after intrahepatic recurrence was allocated to control group.Patients＇ baseline,survival data,serum AFP assay,complications and adverse reactions were recorded and compared.Recurrence rate and prognostic factors of RFA group were analyzed.【Results】 The difference of the baselines between both groups were no significant（P〉 0.05）.The median survival time of RFA group was longer than that of the control group（P〈 0.05）.The serum AFP level decreased after the treatment in RFA group（P 〈0.05）,while the serum AFP level increased after the treatment in control group（P〈 0.05）.Compared with cases in the control groups,the most common early complication in RFA group was liver subcapsular hemorrhage（8/26）;the most common adverse reactions in RFA group were fever（24/26）,pain（26/26）,gastrointestinal symptoms（11/26） which could be tolerated by all the patients.The recurrence rate of RFA group was 81%（21/26）.The risk factors of recurrence after RFA were numbers and diameters of the tumor nodules,preoperative portal vein tumor thrombosis undergoing RFA,early recurrence following liver transplantation（P 〈0.05）.【Conclusion】 The treatment of RFA is a safe and minimally invasive procedure which is strongly recommended for intrahepatic recurrence following liver transplantation for hepatocellular carcinoma.
出处
《中国现代医学杂志》
CAS
CSCD
北大核心
2010年第23期3647-3650,3653,共5页
China Journal of Modern Medicine
基金
国家十一五重大专项(No:2008ZX10002-026)
国家重点基础研究发展计划(973计划()No:2009CB522404)
广东省科技计划项目重大专项(No:2007A032000001)
中山大学医科青年教师科研启动基金(No:2008008)
关键词
肝癌
肝移植
复发
射频消融
hepatocellular carcinoma（HCC）
recurrence
liver transplantation
radio-frequency ablation（RFA）
