摘要
目的研究影响肝细胞癌患者射频消融术(RFA)治疗10年长期效果的相关因素。方法将医院2007年1月~2009年1月间收治的210例行RFA治疗的肝细胞癌患者纳为研究对象,从患者手术后随访至2019年1月31日,统计患者RFA治疗效果与随访结局,根据临床与文献,筛选出12个可能影响RFA治疗效果的相关因素,分析各亚组生存曲线差异,将生存曲线存在差异的因素纳入COX回归模型,分析影响肝细胞癌RFA治疗患者10年长期生存期的独立因素。结果 210例肝细胞癌患者中首次完全消融率为89.05%,患者术后均未出现严重并发症,大部分患者术后1周内均出院;随访至2019年1月31日,共144例患者死亡,32例复发;单因素分析提示,肿瘤数目、肿瘤直径、消融安全边界、肿瘤是否临近大血管、肝功能Child-Pugh分级、首次消融效果、PLT、AFP及肝癌BCLC分级均与肝细胞癌RFA治疗患者10年生存期相关(P<0.05);COX多因素分析结果提示,肿瘤数目、肿瘤直径、消融安全边界、肝功能Child-Pugh分级是影响肝细胞癌患者RFA治疗10年生存期的独立因素。结论 RFA在治疗肝细胞癌中具有微创高效的优势,而肿瘤数目、肿瘤大小、消融安全边界及肝功能Child-Pugh分级是影响RFA治疗10年长期疗效的独立因素,建议临床根据患者肝病背景及肿瘤情况,选择合适的治疗方式。
Objective To investigate the long-term efficacy of a decade after radiofrequency ablation(RFA)for patients with hepatocellular carcinoma(HCC).Methods Two hundred and ten patients with HCC underwent RFA treatment were enrolled in this study.The patients were followed up for ten to twelve years after surgery,and the treatment efficacy and outcome of RFA were recorded.According to the clinical experience and literature,12 relevant factors that may affect the therapeutic efficacy of RFA were selected,and the differences in survival curves of each subgroup were analyzed.The factors with differences in survival curves were incorporated into COX regression model to analyze the independent factors affecting the 10-year long-term survival of patients treated with RFA for hepatocellular carcinoma.Results The first complete ablation rate was 89.05%among 210 patients.No serious complications occurred after the operation.Most patients were discharged within 1 week after surgery.At the end of the follow-up,a total of 144 patients died and 32 patients relapsed;Univariate analysis suggested that the tumor number,tumor diameter,safe margin of ablation,whether the tumor is adjacent to a large blood vessel,the Child-Pugh classification,the first ablation effect,PLT,AFP,and BCLC grade were all associated with 10-year survival of HCC patients after RFA(P<0.05);COX multivariate analysis showed that tumor number,tumor diameter,ablation safety margin,and Chind-Pugh classification were independent factors affecting the 10-year survival of patients with hepatocellular carcinoma after RFA.Conclusion RFA has the advantages of minimal invasive and high efficiency in the treatment of hepatocellular carcinoma,while the long term efficacy is affected by the tumor number,tumor size,ablation safety boundary and child Pugh classification of liver function,so the treatment plan should be selected based on the patients′condition.
作者
陈晖
左琳琳
李木松
刘猛
CHEN Hui;ZUO Lin-lin;LI Mu-song;LIU Meng(Sixth Division of Liver Department,Baoding Infectious Diseases Hospital,Baoding 071000,China;Third Division of Liver Department,Baoding Infectious Diseases Hospital,Baoding 071000,China;Fifth Division of Liver Department,Baoding Infectious Diseases Hospital,Baoding 071000,China;Second Division of Tuberculosis Department,Baoding Infectious Diseases Hospital,Baoding 071000,China)
出处
《肝脏》
2020年第9期922-925,共4页
Chinese Hepatology
关键词
肝细胞癌
射频消融
10年长期有效性
Hepatocellular carcinoma
Radiofrequency ablation
Long-term efficacy
