Radiofrequency Ablation In The Treatment Of Hepatocellular Carcinoma

Objective to observe the adverse reactions of radiofrequency ablation(RFA)in the treatment of hepatocellular carcinoma(HCC),and compare the efficacy with surgical hepatectomy,so as to provide a reasonable choice for the clinical treatment of small and medium-sized hepatocellular carcinoma.Methods clinical data of patients with HCC treated with RFA in the first affiliated hospital of guangxi medical university from 2011 to 2017 were retrospectively studied.According to the stages and grades of adverse reactions in RFA,the incidence of adverse reactions was calculated and the causes were analyzed.The survival rate,median tumor-free survival and recurrence rate of the RFA group and the OHR group and the LHR group were compared,and the efficacy and prognostic factors of RFA,OHR and laparoscopic hepatectomy for HCC patients were analyzed.Results a total of 511 patients with routine RFA therapy,radiofrequency ablation line 608 times,27 cases of liver was observed radiofrequency ablation serious adverse reactions/events,including bile duct injury,bile leakage,and 6patients with biliary fistula,needle road planting transfer 7 cases,diaphragm and lung injury in 1 case,2 cases of ascites,liver abscess 2 cases,the lesion was damaged in 2 cases,suspend the radio frequency(RFA)in 2 cases,focal hemorrhage in 5 cases.Common RFA of mild adverse reactions,respectivelyfever > 38.5 ?(78 cases),pain(drug treatment)(91 cases),transient liver function damage(262 cases),lesions within a small amount of bleeding(without treatment,5 cases),a small chest water(without processing,19 cases).In the RFA efficacy analysis,160 cases in the RFA group were selected and 80 cases in the OHR group and 80 cases in the LHR group during the same period by screening the RFA cases from 2014 to 2017 and collecting the surgical treatment cases at the same period.The total follow-up time was 6 to 60 months,with a median follow-up time of 840 days.The median DFS of RFA group,OHR group and LHR group were 645 d,714d and 748 d,respectively,with statistically significant differences(p<0.05).The 1-year,2-year and 3-year overall survival rates(OS)of the RFA group,OHR group and LHR group were 82.8%,66.2%and 43.9%,respectively.90.0%,68.1%,44.4%,92.8%,75.9%,42.5%,1-year overall survival rate difference was statistically significant(p<0.05);The recurrence rates of RFA group,OHR group and LHR group 1,2 and 3 years were 20.3%,35.6% and 39.2% respectively.17.7%,26.2%,35.0%;The differences were statistically significant(p<0.05).For patients with liver fibrosis/cirrhosis or older than 60 years old,DFS of RFA group was similar to that of OHR group and LHR group(608d vs.605 d vs.667 d,p>0.05),and the difference was not statistically significant.For patients with tumor diameter less than 3cm,the DFS of RFA group was comparable to that of OHR group and LHR group(608d vs.651 dvs 658d,p>0.05).COX regression model analysis showed that surgical approach and degree of liver fibrosis/cirrhosis were independent risk factors for DFS and OS.Conclusion(1)RFA treatment of small and medium-sized liver cancer patients with fewer complications;(2)the local tumor control rate and short-term efficacy are lower than OHR and LHR,while the long-term efficacyis similar to OHR and LHR.(3)for elderly HCC patients with liver cirrhosis,the therapeutic effect of RFA is comparable to that of OHR and LHR,so RFA is the treatment option for elderly liver cancer patients with liver cirrhosis.