射频消融与外科手术在富动脉血供肿块型肝内胆管癌中的疗效对比OACSTPCD
Comparison of therapeutic effectiveness of radiofrequency ablation and surgical procedures in patients with intrahepatic mass-forming cholangiocarcinoma with rich arterial blood supply
目的 探讨射频消融与外科手术在富动脉血供肿块型肝内胆管癌(IMCC)治疗中的效果差异.方法 回顾性分析2014年9月至2020年4月丽水市中心医院和广西医科大学第一附属医院经病理证实且在磁共振增强扫描中呈现富动脉血供的IMCC患者的临床资料.按根治方法分为手术组(n=24)及介入组(n=13),采用t检验和Mann-whitney U检验比较两组临床、病理及影像学资料,采用Kaplan-Meier分析和对数秩检验进行组间生存率分析.结果 两组患者的术前临床一般资料、实验室检查结果、病灶的术前影像表现、术后肿瘤病理分化程度等资料的对比差异均无统计学意义(均P>0.05).介入组术后总并发症发生率低于手术组[38.5%(5/13)vs 91.7%(22/24),Z=-3.432,P=0.001].随访0.6～109.3个月,期间手术组死亡7例、存活17例、复发12例,平均生存时间82.2个月,总生存率(OS)为70.8%,无瘤生存率(RFS)为37.2%,1、3、5年生存率分别为91.7%、79.2%、70.8%,1、3、5年复发率分别为13.6%、40.9%、50.4%;介入组死亡4例、存活9例、复发7例,平均生存时间84.7个月,OS为67.3%,RFS为44.9%,1、3、5年生存率分别为100.0%、84.6%、67.3%,1、3、5年复发率分别为15.4%、46.2%、55.1%;两组OS(χ2=0.002,P=0.969)与RFS(χ2=0.009,P=0.923)差异均无统计学意义.结论 射频消融与外科手术对富动脉血供IMCC具有相似的治疗效果.
Objective Discussing the differences in treatment outcomes between radiofrequency ablation(RFA)and surgical procedures in patients with intrahepatic mass-forming cholangiocarcinoma(IMCC)with rich arterial blood supply.Methods A retrospective analysis was conducted on patients with IMCC confirmed by pathology and showing rich arterial blood supply on enhanced magnetic resonance imaging(MRI)scans at Central Hospital in Lishui City and the First Affiliated Hospital of Guangxi Medical University from Sep.2014 to Apr.2020.The patients were divided into the surgical group(24 cases)and the interventional group(13 cases)based on treatment methods.Clinical,pathological,and radiological data were compared between the two groups using t-tests and Mann-Whitney U tests.Kaplan-Meier analysis and Log-rank tests were used to analyze the intergroup survival rates.Results There was no statistical significant difference in preoperative general clinical data,laboratory test results,imaging findings of lesions,or postoperative tumor pathological differentiation between the two groups(all P>0.05).The total postoperative complications rate in the interventional group was significantly lower than that in the surgical group[38.5%(5/13)vs 91.7%(22/24),Z=-3.432,P=0.001].During the follow-up period ranging from 0.6 to 109.3 months,the surgical group had 7 deaths,17 survivors,and 12 recurrences,with an average survival time of 82.2 months.The overall survival(OS)rate was 70.8%,and the relapse-free survival(RFS)rate was 37.2%.The 1-,3-,and 5-year survival rates were 91.7%,79.2%,and 70.8%respectively,while the 1-,3-,and 5-year recurrence rates were 13.6%,40.9%,and 50.4%respectively.The intervention group had 4 deaths,9 survivors,and 7 recurrences,with an average survival time of 84.7 months.The OS was 67.3%,and the RFS was 44.9%.The 1-,3-,and 5-year survival rates were 100.0%,84.6%,and 67.3%respectively,while the 1-,3-,and 5-year recurrence rates were 15.4%,46.2%,and 55.1%respectively.No statistically significant difference was found in OS(χ2=0.002,P=0.969)and RFS(χ2=0.009,P=0.923)between the two groups.Conclusion RFA and traditional surgical procedures have comparable therapeutic effects in patients with IMCC with rich arterial blood supply.
沈少博;彭帅;吴慧;张坤;李芳;李炳荣;纪建松
丽水市中心医院放射科,浙江 丽水 323000广西医科大学第一附属医院 放射科,广西 南宁 530021丽水市中心医院肿瘤介入中心,浙江 丽水 323000丽水市中心医院肝胆外科,浙江 丽水 323000
临床医学
肝内胆管癌富动脉血供动脉增强射频消融手术预后
intrahepatic cholangiocarcinomarich arterial blood supplyarterial enhancementradiofrequency ablationsurgeryprognosis
《肝胆胰外科杂志》 2024 (004)
205-210 / 6
丽水市科技计划项目(2022GYX35,2023SJZC031).
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