| Objective: To investigate the effect of radiofrequency ablation(RFA),radiofrequency ablation combined with transcatheter arterial chemoembolization(TACE)and surgical resection for small hepatocellular carcinoma(HCC).Methods: The clinical data of 129 cases of hepatocellular carcinoma from september 2009 to september 2014 in Department of hepatobiliary surgery of Guizhou province Hospital were retrospectively analyzed,all cases were diagnosed with pathologically,all cases were divided into radiofrequency ablation group(42 cases)? Radiofrequency ablation combined with hepatic artery embolization chemotherapy group(combined group 46 cases)?Surgical resection group(41cases).The recurrence rate,survival rate and complications of the three groups were analyzed.All the data were analyzed by SPSS22.0 software package,the analysis of variance was used to compare the measurement data,the LSD test was used in pairwise comparison,and the Chi-Square test was used to compare the classified data(The level of the test was a=0.05 and the difference was statistically significant when P < 0.05).The survival rate and complications were compared,and the long-term effects of the three treatment methods were compared between the small hepatocellular carcinoma with tumor diameter ? 3 cm and the small liver cancer with tumor diameter > 3 cm and ? 5 cm.Results: In the radiofrequency ablation group,the1?2?3 years recurrence rates were 11.9%? 38.1% and 57.1%,and the survival rates were 95.2%?88.1%and 76.2%;In the radiofrequency ablation combined with hepatic artery embolization chemotherapy group,the1?2?3 years recurrence rates were 6.5%?19.7% and 37.0%,and the survival rates were 95.7%?87.0% and 73.9%;In the surgical resection group,the1? 2?3 years recurrence rates were 7.3%?17.1% and 39.0%,and the survival rates were 95.1% ? 87.8% and 75.6%.The results of statistical analysis showed that radiofrequency ablation,radiofrequency ablation combined with transcatheter arterial chemoembolization and resection had no significant difference in recurrence rate and survival rate(P > 0.05).In the tumor size ?3cm group,radiofrequency ablation,radiofrequency ablation combined with transcatheter arterial chemoembolization and resection had no significant difference in recurrence rate and survival rate(P > 0.05).In the tumor size 3-5cm group,There were no significant difference in survival rate(P > 0.05),the recurrence rate in radiofrequency ablation group was higher than that in resection group and radiofrequency ablation combined with hepatic artery embolization group(P < 0.05),the recurrence rate of surgical resection group and radiofrequency ablation combined with hepatic artery embolization group was same(P > 0.05).Postoperative complications: Pain: radiofrequency ablation group(3 cases)?combined group(4 cases)and surgical resection group(34 cases)need to be treated with painkillers.Fever: radiofrequency ablation group(10 cases)?combined group(13 cases)and surgical resection group(24 cases).Infection: Pulmonary infection occurred 3 cases in radiofrequency ablation group?4 cases in combined group?5 cases in surgical resection group;Infection of incisional wound occurred 10 cases in surgical resection group;Lung infection with incision occurred 6 cases in surgical resection group.Abdominal bleeding: Abdominal bleeding occurred 5 cases in the resection group,1 cases in the combined group.Pleural effusion: 1 case occurred in radiofrequency ablation group and 6 cases in surgical resection group.Adjacent organ injury: injury of diaphragm occurred 2 cases in radiofrequency ablation group?1 case in combined group;intestinal fistula occurred 1 case in radiofrequency ablation group?1 case in combined group.Comparison of complications in three groups,There was no significant difference between radiofrequency ablation group and radiofrequency ablation combined with hepatic artery chemoembolization group(P > 0.05).Pain,fever,incision infection,intraperitoneal hemorrhage and pleural effusion in the resection group were significantly higher than those in the radiofrequency ablation group and the radiofrequency ablation combined with hepatic artery embolization group(P < 0.05).The complications of adjacent organ injury mainly occurred in radiofrequency ablation group and radiofrequency ablation combined with hepatic artery chemoembolization group,there was no significant difference among the three groups(P > 0.05).Conclusion: Radiofrequency ablation,radiofrequency ablation combined with transcatheter arterial chemoembolization can achieve long-term results with surgical resection for patients with small hepatocellular carcinoma,and the complications were significantly reduced.For small hepatocellular carcinoma with tumor diameter > 3 cm and ? 5 cm,the long-term effect of radiofrequency ablation combined with hepatic arterial chemoembolization and surgical resection was superior to that of radiofrequency ablation alone. |
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