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首页> 外文期刊>World Journal of Gastroenterology >Long-term outcomes of hepatectomy vs percutaneous ablation for treatment of hepatocellular carcinoma < or =4 cm.
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Long-term outcomes of hepatectomy vs percutaneous ablation for treatment of hepatocellular carcinoma < or =4 cm.

机译：肝切除术与经皮消融治疗肝癌的远期结果<或= 4 cm。

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AIM: To determine which treatment modality--hepatectomy or percutaneous ablation--is more beneficial for patients with small hepatocellular carcinoma (HCC) (< or =4 cm) in terms of long-term outcomes. METHODS: A retrospective analysis of 149 patients with HCC < or =4 cm was conducted. Eighty-five patients underwent partial hepatectomy (anatomic in 47 and non-anatomic in 38) and 64 underwent percutaneous ablation (percutaneous ethanol injection in 37, radiofrequency ablation in 21, and microwave coagulation in 6). The median follow-up period was 69 mo. RESULTS: Hepatectomy was associated with larger tumor size (P<0.001), whereas percutaneous ablation was significantly associated with impaired hepatic functional reserve. Local recurrence was less frequent following hepatectomy (P<0.0001). Survival was better following hepatectomy (median survival time: 122 mo) than following percutaneous ablation (median survival time: 66 mo; P=0.0123). When tumor size was divided into < or =2 cm vs >2 cm, the favorable effects of hepatectomy on long-term survival was seen only in patients with tumors>2 cm (P=0.0001). The Cox proportional hazards regression model revealed that hepatectomy (P=0.006) and tumors < or =2 cm (P=0.017) were independently associated with better survival. CONCLUSION: Hepatectomy provides both better local control and better long-term survival for patients with HCC < or =4 cm compared with percutaneous ablation. Of the patients with HCC < or =4 cm, those with tumors >2 cm are good candidates for hepatectomy, provided that the hepatic functional reserve of the patient permits resection.
机译：目的：确定哪种治疗方式-肝切除术或经皮消融术-从长期结局来看对小肝细胞癌（HCC）（<或= 4 cm）患者更有利。方法：对149例HCC≤4cm的患者进行回顾性分析。 85例患者接受了部分肝切除术（47例接受了解剖切除，38例接受了非解剖切除），64例接受了经皮消融（37例接受了经皮乙醇注射，21例接受了射频消融，6例接受了微波凝固）。中位随访期为69个月。结果：肝切除术与更大的肿瘤大小相关（P <0.001），而经皮消融与肝功能储备受损显着相关。肝切除术后局部复发的频率较低（P <0.0001）。肝切除术后的生存期（中位生存期：122 mo）比经皮消融术后的生存期（中位生存期：66 mo； P = 0.0123）更好。将肿瘤大小分为2 cm或2 cm或2 cm以上时，仅在2 cm以上的肿瘤患者中观察到肝切除术对长期生存的有利影响（P = 0.0001）。 Cox比例风险回归模型显示，肝切除术（P = 0.006）和肿瘤<或= 2 cm（P = 0.017）与更好的生存率独立相关。结论：与经皮消融相比，肝切除术可为HCC <或= 4 cm的患者提供更好的局部控制和更好的长期生存。在HCC <或= 4 cm的患者中，肿瘤大于2 cm的患者是肝切除的良好候选者，条件是该患者的肝功能储备允许切除。

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