关键词: 原发性肝癌, 肝叶切除, 射频消融, 预后

Abstract: Objective To explore the long-term prognosis in patients with primary liver cancer after surgical resection or radiofrequency ablation（RAF）. Methods Clinical data of 218 patients with primary liver cancer who received surgical resection or RAF between July 2009 and December 2011 were retrospectively analyzed. 106 cases among them received surgical resection,while the other 112 cases received RFA. The prognosis in the two groups was compared. Results Lesion clearance rates in the two groups were both 100.0%; No patients in RFA group needed blood transfusion,whereas 4.7% of patients in the operation group received blood transfusion（P<0.05）;The average operation time in RFA group was shorter than that in surgical resection group [（30.5±7.4） min vs.（146.2±30.4） min,P<0.05];The hospitalization stay in RFA group was also shorter than that in the surgical resection group [（7.3±0.9） d vs.（12.4±2.7） d,P<0.05];40.2% of patients in RFA group,while 29.2% in surgical resection group had a body temperature higher than 38 ℃,without statistical difference（P<0.05）;Abdominal infection occurred in 1.8% of patients in RFA group and 5.7% of patients in surgical resection group（P<0.05）;The percentages of patients with pleural and/or peritoneal effusion,or hemoglobin （Hb） levels less than 90g/L or serum albumin（ALB） levels less than 30g/L in RFA group were 15.2%,15.2% and 17.0%,respectively,much lower than those in surgical resection group（31.1%,35.8% and 36.8%,respectively,P<0.05 for all）;Enhanced MRI were conducted in all the patients to exam the lesion clearance,and 5.4% of patients in RFA group had tumor residue,while the full clearance was obtained in surgical resection group（P<0.05）;The one year,three year and five year survival rates in RFA group were 92.9%,39.3% and 17.9%,respectively,which were lower than those in surgical resection group （97.2%,56.6% and 29.2,respectively）;The one year,three year and five year recurrence and metastasis rates in RFA group were 39.3,69.6% and 98.2%,respectively,which were lower than those in surgical resection group（29.2%,51.9% and 86.8%,respectively）,with the three and five year recurrence and metastasis rates statistically significantly different between the two groups （P<0.05 for both）. Conclusion RFA can reduce the operation time and postoperative complications,but it is discounted with the possibility of tumor residue and relatively poor long-term prognosis in treatment of patients with primary liver cancer.

Key words: Hepatoma, Hepalobectomy, Radiofrequency ablation, Prognosis