手术不可行的早期肝癌患者接受经皮微波消融治疗后的长期疗效

摘要

Objective To investigate the efficiency and prognostic factors for the patients with hepatocel-lular carcinoma (HCC) at unresectable early stage when treated with percutaneous microwave ablation. Methods From January 2007 to January 2010 , 105 cases of at unresectable early stage were treated with percutaneous microwave ablation. Complete response rate, major complication rate, overall survival rates, disease-free survival rate were observed and prognostic risk factors were analyzed. Results The complete response rate was 95.7%. The major complication ratewas 3.8%. The 1-, 3-, and 5-year overall survival rates were 97.1%, 66.7%, 46.7%, and the corresponding disease-free survival rates were 82.9%, 48.6%, 31.4%, respectively. Age > 65 year and tumor size > 3 cm were independent risks for disease-free survival. Age > 65 year and recurrence were independent risks for overall survival. Conclusions Percutaneous microwave ablation is a safe and efficient ther-apy for HCC at unresectable early stage.%目的：分析手术不可行的早期肝癌（HCC）患者接受经皮微波消融（PMVA）治疗后的长期疗效。方法：选取2007年1月至2010年1月105例手术不可行的早期肝癌患者经皮热消融治疗，观察肿瘤完全消融率、严重并发症发生率、总体生存率、无瘤生存率并分析预后相关影响因素。结果：肿瘤完全消融率95．7％，并发症发生率3．8％，1、3、5年总体生存率分别为97．1％、66．7％、46．7％，1、3、5年无瘤生存率分别为82．9％、48．6％、31．4％。年龄＞65岁和肿瘤最大直径≥3 cm 是影响术后无瘤生存率独立危险因素；年龄＞65岁和肿瘤复发是总生存率的独立风险因素。结论：对于手术不可行的早期HCC患者，PMWA是安全且疗效理想的治疗方法，可作为该类HCC患者的首选治疗。