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논문 기본 정보
- 자료유형
- 학술저널
- 저자정보
- 저널정보
- 대한외과학회 Annals of Surgical Treatment and Research Annals of Surgical Treatment and Research Vol.90 No.3
- 발행연도
- 2016.2
- 수록면
- 147 - 156 (10page)
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초록· 키워드
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Purpose: This retrospective study was an investigation of overall survival (OS), disease-free survival (DFS) and prognostic factors affecting OS and DFS in cirrhotic patients who received intraoperative radiofrequency ablation (IORFA).
Methods: Between April 2009 and November 2013, 112 patients (94 men, 84%; 18 women, 16%) underwent IORFA for 185 cases of hepatocellular carcinomas (HCC). Repeat IORFA was done in 9 patients during the same period (total of 121 treatments).
Results: All patients were followed-up for at least 12 months (mean follow-up, 32 months). Surgical resection combined with IORFA was performed in 20 patients. The technical effectiveness at 1 week was 91.78% (111 of 121). Readmission was 9.1% (11 of 121) and the most common cause was ventral hernia. Procedure-related mortality was 2.7% (3 of 112) and continued fatal biliary leakage was 1.8% (2 of 112). Local recurrence developed in 10 patients (8.9%). Most recurrence was intrahepatic. Cumulative survival was assessed in 33 patients who received IORFA as primary treatment (naive patients) and 79 non-naive patients. The cumulative DFS and OS rate at l and 3 years was 54% and 24%, and 87% and 66%, respectively. Moderate ascites (P = 0.001), tumor located segment I (P = 0.001), portal vein thrombosis (P = 0.001) had poor survival were significant factors by multivariate analysis.
Conclusion: IORFA alone or in combination with surgical resection extends the spectrum of liver surgery. A fundamental understanding of RFA, additional comorbidities, and postablation complication are necessary to maximize the safety and efficacy of IORFA for treating HCC with cirrhosis.
Methods: Between April 2009 and November 2013, 112 patients (94 men, 84%; 18 women, 16%) underwent IORFA for 185 cases of hepatocellular carcinomas (HCC). Repeat IORFA was done in 9 patients during the same period (total of 121 treatments).
Results: All patients were followed-up for at least 12 months (mean follow-up, 32 months). Surgical resection combined with IORFA was performed in 20 patients. The technical effectiveness at 1 week was 91.78% (111 of 121). Readmission was 9.1% (11 of 121) and the most common cause was ventral hernia. Procedure-related mortality was 2.7% (3 of 112) and continued fatal biliary leakage was 1.8% (2 of 112). Local recurrence developed in 10 patients (8.9%). Most recurrence was intrahepatic. Cumulative survival was assessed in 33 patients who received IORFA as primary treatment (naive patients) and 79 non-naive patients. The cumulative DFS and OS rate at l and 3 years was 54% and 24%, and 87% and 66%, respectively. Moderate ascites (P = 0.001), tumor located segment I (P = 0.001), portal vein thrombosis (P = 0.001) had poor survival were significant factors by multivariate analysis.
Conclusion: IORFA alone or in combination with surgical resection extends the spectrum of liver surgery. A fundamental understanding of RFA, additional comorbidities, and postablation complication are necessary to maximize the safety and efficacy of IORFA for treating HCC with cirrhosis.
목차
INTRODUCTION
METHODS
RESULTS
DISCUSSION
REFERENCES
참고문헌 (29)
참고문헌 신청
Raut CP, Izzo F, Marra P, Ellis LM, Vauthey JN, Cremona F, et al. Significant long-term survival after radiofrequency ablation of unresectable hepatocellular carcinoma in patients with cirrhosis. Ann Surg Oncol 2005;12:616-28.
El-Gendi A, El-Shafei M, Abdel-Aziz F, Bedewy E. Intraoperative ablation for small HCC not amenable for percutaneous radiofrequency ablation in Child A cirrhotic patients. J Gastrointest Surg 2013; 17:712-8.
Nishikawa H, Inuzuka T, Takeda H, Nakajima J, Matsuda F, Sakamoto A, et al. Comparison of percutaneous radiofrequency thermal ablation and surgical resection for small hepatocellular carcinoma in patients with cirrhosis. BMC Gastroenterology 2011;11:143.
Ribeiro MA Jr, Rodrigues JJ, Habr-Gama A, Chaib E, D'Ipolitto G, Fonseca AZ, et al. Radiofrequency ablation of primary and metastatic liver tumors: 4 years experience. Hepatogastroenterology 2007; 54:1170-5.
Kim YS, Rhim H, Lim HK, Choi D, Lee WJ, Jeon TY, et al. Intraoperative radiofrequency ablation for hepatocellular carcinoma: long-term results in a large series. Ann Surg Oncol 2008;15:1862-70.
El-Gendi A, El-Shafei M, Abdel-Aziz F, Bedewy E. Intraoperative ablation for small HCC not amenable for percutaneous radiofrequency ablation in Child A cirrhotic patients. J Gastrointest Surg 2013; 17:712-8.
Nishikawa H, Inuzuka T, Takeda H, Nakajima J, Matsuda F, Sakamoto A, et al. Comparison of percutaneous radiofrequency thermal ablation and surgical resection for small hepatocellular carcinoma in patients with cirrhosis. BMC Gastroenterology 2011;11:143.
Ribeiro MA Jr, Rodrigues JJ, Habr-Gama A, Chaib E, D'Ipolitto G, Fonseca AZ, et al. Radiofrequency ablation of primary and metastatic liver tumors: 4 years experience. Hepatogastroenterology 2007; 54:1170-5.
Kim YS, Rhim H, Lim HK, Choi D, Lee WJ, Jeon TY, et al. Intraoperative radiofrequency ablation for hepatocellular carcinoma: long-term results in a large series. Ann Surg Oncol 2008;15:1862-70.
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UCI(KEPA) : I410-ECN-0101-2016-514-002640580