关键词: 肝尾状叶, 肝细胞癌, 超声引导下经皮射频消融, 生存分析

Abstract: Objective Comparison of ultrasound-guided percutaneous radiofrequency ablation and surgical resection in the treatment of hepatocellular carcinoma of caudate lobe. Methods Thirty-four patients with caudate lobe hepatocellular carcinoma admitted to hospital from January 2005 to January 2015 were included, including 12 patients who underwent ultrasound-guided percutaneous radiofrequency ablation (ablation group), including 10 males and 2 females. The age was (56.7±6.8) years old; There were 22 patients who underwent surgical resection (operation group), including 15 males and 7 females, aged (57.9±10.2) years. The measurement data are expressed as (x ±s), the t-test is analyzed, the counting data is expressed as absolute value, and the chi-square test is used for analysis. Kaplan-Meier method was used for survival analysis. Log Rank test was used to compare the survival curve, and Breslow test was used to test the cross of survival curve. Results The operative time of the ablation group was (50.6±15.4) min, and the intraoperative bleeding volume was (22.8 ±9.6) ml;. The intraoperative bleeding time of the patients in the ablation group was (178.4±35.2) min, and the intraoperative bleeding volume was (402.8±98.4) ml;. There were significant differences in operation time and intraoperative bleeding between the two groups (P<0.05). In the ablation group, the tumor recurrence rates at 1, 2 and 3 years after operation were 8.3% (1 case), 25.0% (3 cases) and 41.7% (5 cases), respectively. The 1 -, 2-and 3-year overall survival rates were 91.6% (1112), 83.3% (10) and 66.7% (8), respectively. In the operation group, the tumor recurrence rates at 1, 2 and 3 years after operation were 9.1% (2 cases), 27.3% (6 cases) and 40.9% (9 cases), respectively. The 1 -, 2-and 3-year overall survival rates were 90.9% (2022), 77.3% (17/22) and 68.2% (15/22), respectively. There was no significant difference in tumor recurrence rate and overall survival rate between the two groups (P>0.05). The incidence of complications was 16.7% (2) in the ablation group and 31.8% (7/22) in the operation group (P<0.05). Conclusion Ultrasound-guided percutaneous radiofrequency ablation is similar to surgical resection in the treatment of caudate lobe hepatocellular carcinoma. At the same time, it can reduce the trauma of patients and reduce the incidence of perioperative complications.

Key words: Caudate lobe of liver, Hepatocellular carcinoma, Ultrasound-guided percutaneous radiofrequency ablation, Survival analysis