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目的探讨肝切除、射频消融及肝移植3种治疗方法对原发性肝癌单个肿瘤的治疗效果,为初始治疗方法的选择提供参考。方法采用回顾性研究,分析从2007年1月至2013年12月在我院接受治疗的术前影像学表现为单个肿瘤的原发性肝癌患者的临床资料共计315例,据治疗方法的不同分为3组:手术切除组153例,射频消融治疗组90例,肝移植组72例。比较3组患者的1、3、5年累积总体生存率及无瘤生存率。结果手术切除组1、3、5年累计生存率分别为92.7%、75.8%、61.9%,无瘤生存率为75.9%、55.8%、33.9%;射频消融组1、3、5年累计生存率分别为88.6%、62.1%、49.7%,无瘤生存率为73.6%、40.6%、18.9%;肝移植组为94.3%、78.3%、72.7%,无瘤生存率为95.6%、86.4%、82.5%。3组患者的总体累积生存率及无瘤生存率差异有统计学意义(P值为0.027及0.000)。结论肝移植治疗单个肿瘤的原发性肝癌可获得较好的5年生存率及无瘤生存率,肝切除与射频消融的早中期疗效相当,但射频消融术在中远期无瘤生存方面略逊于肝切除。
Objective To investigate the curative effect of three kinds of hepatectomy, radiofrequency ablation and liver transplantation on the single tumor of primary hepatocellular carcinoma (HCC), and provide reference for the selection of initial treatment. Methods A retrospective study was conducted to analyze the clinical data of 315 patients with primary hepatocellular carcinoma presenting as a single tumor from January 2007 to December 2013 in our hospital. According to the different treatment methods Three groups: surgical resection group of 153 cases, radiofrequency ablation group of 90 cases, liver transplantation group of 72 cases. The 1, 3, 5-year cumulative overall survival and tumor-free survival rates were compared between the 3 groups. Results The cumulative survival rates at 1, 3 and 5 years in the resection group were 92.7%, 75.8% and 61.9% respectively, and the tumor-free survival rates were 75.9%, 55.8% and 33.9% respectively. The 1-, 3- and 5- year cumulative survival rates Respectively. The tumor-free survival rates were 73.6%, 40.6% and 18.9% respectively in the liver transplantation group and 94.3%, 78.3% and 72.7% in the liver transplantation group. The tumor-free survival rates were 95.6%, 86.4% and 82.5 %. The overall cumulative survival rate and tumor-free survival rate of 3 groups of patients were statistically significant (P = 0.027 and 0.000). Conclusion Liver transplantation for primary hepatocellular carcinoma can achieve a good 5-year survival rate and tumor-free survival rate. The efficacy of hepatectomy and radiofrequency ablation is similar in early and mid-term, but radiofrequency ablation has no long-term survival in the long-term Less than liver resection.