کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
6088175 1207690 2016 8 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
Liver, Pancreas and Biliary TractLaparoscopic ablation therapies or hepatic resection in cirrhotic patients with small hepatocellular carcinoma
ترجمه فارسی عنوان
کبد، پانکراس و ترشحات صفراوی درمانهای تخلیه لاپاروسکوپیک یا رزکسیون کبدی در بیماران مبتلا به سیروز به کارسینوم کبدی کوچک
موضوعات مرتبط
علوم پزشکی و سلامت پزشکی و دندانپزشکی غدد درون ریز، دیابت و متابولیسم
چکیده انگلیسی

BackgroundThe Barcelona Clinic Liver Cancer staging system recommends radiofrequency ablation as treatment of choice for patients with “small” (up to 2 cm in size) hepatocellular carcinoma.AimsAim of the study was to assess whether laparoscopic ablation therapies or hepatic resection could be proposed as alternative option if percutaneous approach is not feasible.MethodsOverall survival and tumour recurrence rate were compared in a retrospective cohort of 176 consecutive patients with small hepatocellular carcinoma on cirrhosis treated by laparoscopic ablation therapies or surgery. To balance the covariates between the two groups, a propensity case-matched analysis was developed to generate a matched sample, which included 76 patients in each arm.ResultsLocal tumour progression (p = 0.005), intra-segmental recurrence (p = 0.0001), and 5-year recurrence rates (80% vs. 60%; p = 0.0014) were significantly higher in the ablation therapies group. The 5-year survival rate were 48% after ablation therapies and 69% after hepatic resection (p = 0.0006). Multivariate analysis showed that MELD score, alpha-fetoprotein value, procedure category and intraoperative restaging were associated with survival, while the surgery was the only independent predictor of intra-hepatic recurrence.ConclusionsThe present study suggests that, if percutaneous ablation is not feasible, hepatic resection may be considered as a sound option in the treatment of small hepatocellular carcinoma.

ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: Digestive and Liver Disease - Volume 48, Issue 2, February 2016, Pages 189-196
نویسندگان
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