| Primary hepatocellular carcinoma,referred to as liver cancer,is a malignant tumor that arises from hepatocytes or biliary epithelial cells.Hepatocellular carcinoma(HCC)accounts for more than 90% of primary hepatocellular carcinoma.The fifth most common malignancy in the world and the second leading cause of cancer-related deaths.The mortality rate of liver cancer in China ranks the second place among all malignant tumors in China.About 383,000 people die of liver cancer every year,accounting for more than 50% of the global death toll from liver cancer,and it is on the rise every year.The majority of hepatectomy resection(HR)and liver transplantation are considered as the major radical treatments for early HCC in the hepatectomy treatment guidelines.However,the shortage of liver transplantation donors and the high cost limit its clinical application.Surgical resection is still the main treatment for liver cancer.With the rise and development of the concept of minimally invasive treatment,local minimally invasive treatment technology has been increasingly used in the clinical treatment of HCC.percutaneous radiofrequency ablation(PRFA)with its simple operation,small trauma,rapid recovery,safe,effective,high repeatability,etc.It is considered to be the third largest treatment of HCC for liver resection and liver transplantation,and it is updated with the replacement of the radio frequency needle in the radiofrequency ablation procedure(from the original a can melt 2 cm of single needle electrode used 5 cm of the umbrella up to now the needle electrode and trocar,etc.),so that the range of radiofrequency ablation in clinical adaptation is also expanding.Objective To investigate the therapeutic effect between percutaneous radiofrequency ablation(PRFA)and hepatectomy resection(HR)in primary hepatocellular carcinoma.Methods Retrospectively analyzed 82 patients with primary single-cell small hepatocellular carcinoma(tumor diameter ? 5.0 cm)admitted to the First Affiliated Hospital of Zhengzhou University from January 2014 to December 2015.Eighty-two patients underwent percutaneous radiofrequency ablation(PRFA)or hepatectomy(HR)as treatment.postoperative liver function,postoperative complications,postoperative hospital stay and hospital costs were compared between PRFA patients and HR patients.According to the tumor diameter,the tumor was divided into tumor group A(3 cm)and tumor group B(3.1 ? 5.0 cm).Among the patients in group A,those who chose PRFA were referred to as group PRFA A(22 cases),those who chose HR were referred to as group HR A(18 cases),those who chose PRFA were referred to as group PRFA B(16 cases),and those who chose HR were referred to as group HR B(26 cases).postoperative 1-year,2-year and 3-year survival rates and recurrence rates of PRFA group A and HR group A were compared,and postoperative 1-year,2-year and 3-year survival rates and recurrence rates of PRFA group B and HR group B were compared,and postoperative 1-year,2-year and 3-year survival rates and recurrence rates of PRFA group A and HR group B were compared,and postoperative 1-year,2-year and 3-year survival rates and recurrence rates of PRFA group B and HR group A were compared.Results postoperative liver function: the P values of liver function(ALT AST ALB TBIL)of PRFA patients and HR patients on the first day after surgery was>0.05,with no statistical significance.The P values of liver function(ALT AST ALB TBIL)of PRFA patients and HR patients on the fourth day after surgery was <0.05,with statistical significance.postoperative liver function in patients who chose PRFA recovered faster than HR patients.postoperative complications: When the pa In was tolerated,no additional pain relief was given.When the pain exceeded the tolerance limit,the dextrozine was given an analgesic effect.Among the patients selected for PRFA,there were 4 cases of fever,2 cases of pain(additional dizocine for pain relief),1 case of skin burns,and 2 cases of pleural effusion.The complication rate was 23.68%(9/38).The patients selected for HR included 2 patients with electrolyte disturbance,3 patient with pain(additional pain relief with dizocine),3 patients with fever,5 patients with pleural effusion or ascites,2 patients with fat liquefaction of incision and 1 patient with bleeding.The incidence of complications was 31.36%(16/44).The P value was <0.05,with statistical significant.percutaneous radiofrequency ablation has lower complications than hepatectomy resection.postoperative hospitalization time and hospitalization cost: postoperative hospitalization time of PRFA patients and HR patients were 4.4 ±1.0 days and 13.4± 2.6 days,respectively.postoperative hospitalization cost was 3.2±0.4 million and 4.9 ±0.6 million,respectively.The P values of hospitalization time and hospitalization cost were both < 0.05,with statistical significant.The hospitalization time and hospitalization cost of PRFA patients were lower than those of HR patients.postoperative 1-year,2-year and 3-year survival rates and recurrence rates: The 1-,2-,and 3-year survival rates of PRFA A and HR A in group A were 90.9%,81.8%,72.7%,94.4%,and 88.8%,respectively.72.7%.The recurrence rates at 1,2,and 3 years were 13.6%,31.8%,40.9%,and 11.1%,22.2%,and 33.3%,respectively.The survival rate and recurrence rate p were both >0.05,no statistical significance.The 1-,2-,and 3-year survival rates of PRFA B and HR B in group B were 81.8%,68.7%,43.7.0%,and 92.3%,80.7%,and 69.2%,respectively.The recurrence rates at 1,2,and 3 years were 18.7%,43.7%,56.3%,and 23.1%,34.6%,and 46.2%,respectively.The survival rate and recurrence rate p were both >0.05,no statistical significance.The survival rate and recurrence rate at 1,2 and 3 years of PRFA A and HR B surgery were tested by chi-square test,all P <0.05,with statistical significance.Results The survival rate and recurrence rate at 1,2 and 3 years after surgery in PRFA B and HR A were all P <0.05,with statistical significant.Conclusion 1.percutaneous radiofrequency ablation has the advantages of simple operation,short operation time,small trauma,safe and effective,and strong repeatability.Compared with hepatectomy resection,percutaneous radiofrequency ablation has faster recovery of liver function,shorter postoperative hospitalization time,lower hospitalization cost and lower incidence of postoperative complications.2.Compared with hepatectomy resection,percutaneous radiofrequency ablation has similar short-term efficacy for small liver cancer.For patients with small liver cancer,radiofrequency ablation can be used as an alternative therapy for hepatectomy. |
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