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目的:总结复发性小肝癌的外科治疗方法。方法回顾性分析2005年1月至2008年6月第1次手术后复发的小肝癌35例患者的临床资料,分为再次手术组和射频消融组,比较两组术后3年生存及复发情况。结果再次手术组18例,均行肿瘤局部切除术,射频消融组17例,均行局部射频消融治疗。再次手术组3年无瘤存活率(66.1%,11/18)高于射频消融者(47.1%,8/17)(P<0.05),手术切除肿瘤局部复发率(22.2%,4/18)低于射频消融(35.6%,5/17)(P<0.05),直径<3cm的肿瘤,采用手术或射频消融治疗3年生存率和复发率差异无统计学意义(P>0.05),3～5cm肿瘤采用手术治疗者3年生存率高于射频消融治疗,复发率低于射频消融治疗(均P>0.05)。结论对复发性小肝癌瘤体小于3mm者应根据患者情况并充分考虑患者意愿进行治疗,对肿瘤为者则以手术为宜。
Objective: To summarize the surgical treatment of recurrent small hepatocellular carcinoma. Methods The clinical data of 35 patients with recurrent small hepatocellular carcinoma after surgery from January 2005 to June 2008 were retrospectively analyzed and divided into three groups: reoperation group and radiofrequency ablation group. The 3-year survival and recurrence after operation . Results In the reoperation group, 18 patients underwent local excision of the tumor and radiofrequency ablation group of 17 patients underwent local radiofrequency ablation. The 3-year tumor-free survival rate (66.1%, 11/18) in the reoperation group was significantly higher than that in the radiofrequency ablation group (47.1%, 8/17) (P <0.05) There was no significant difference in the 3-year survival rate and recurrence rate between radiofrequency ablation (35.6%, 5/17) (P <0.05) and diameter <3 cm tumor using radiofrequency ablation or radiofrequency ablation (P> 0.05) The 3-year survival rate of patients with 5cm tumor was higher than radiofrequency ablation, the recurrence rate was lower than that of radiofrequency ablation (all P> 0.05). Conclusions For patients with recurrent small hepatocellular carcinoma whose tumor size is less than 3mm, the treatment should be based on the patient’s condition and the patient’s intention should be taken into full consideration.