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Action of intraoperative radio-frequency for the prolongation of the survival period in patient with multiple large hepatic cancer PDF Print E-mail
Sunday, 28 September 2008 04:05



Authors:CHENG Xiang-dong,DU Yi-an,HUANG Ling    
From:Department of Hepatobiliary Pancreatic Surgery,Zhejiang Cancer Hospital,Hangzhou 310022,China

 

【Abstract】    Objective To explore the optimum program for the treatment of patient with multiple large hepatic cancer and analyze mechanism of the action of intraoperative radio-frequency.Methods Forty five admitted patients with multiple large hepatic cancer from January 2003 to January 2007 were classified into:simple hepatic artery embolization chemotherapy group(TACE group,n=20);local resection of multiple lesion +TACE(LR+TACE group,n=13);intraoperative radio-frequency ablation+TACE(IRFA+TACE group,n=12).A comparison of the complete remission rate and survival rate between the 3 groups was made.We analyzed the survival rate with Kaplan-Meier method,and checked the validity with long-rank method.Results No patient died in the treatment.The complete remission rate in IRFA+TACE,LR+TACE and TACE groups were 41.70%,46.20% and 25.50% respectively,being highest in LR+TACE group but had no statistical significance(P=0.405).Recent survival rate(0.5,1-year survival rate)had no notable difference,but the remote survival rate in IRFA+TACE group was significantly higher than that of the other 2 groups,the 1.5 years and 2.0 years survival rate in the 3 groups being 75.00%,69.20%,30.00% and 50.00%,23.10%,10.00% respectively(P<0.05).The mean survival period in the 3 groups being 26.56 months,21.04 months,16.41 months respectively and had significant difference(P<0.001).Kaplan-Meier survival curve suggested the overall survival rate in IRFA group was significantly higher than that of the other 2 groups(P<0.05).As compared with the elevation of the overall survival rate,there was no significant difference of tumorless survival rate between IRFA+TACE group and LR+TACE group(P=0.645),and the tumorless survival rate in TACE group was still significantly lower than that in the other 2 groups(P<0.022).The prolongation of the survival period in patients with multiple macronodular hepatic after IRFA+TACE treatment was mainly embodied in the prolongation of survival period in tumor carrying patient,and local resection was unable to prolong the survival period in tumor carrying patient(P=0.028).Conclusion Combination treatment with IRFA and TACE is a safe optimum therapeutic program in patients with multiple macronodular hepatic cancer for the prolongation of survival period.The mechanism may be the enhancement of cellular immunity,maintaining a dynamic balance between the host and the tumor which takes part in the action on the prolongation of the overall survival period.

【Keywords】  multiple hepatic cancer;large hepatic cancer;radio-frequency ablation;cellular immunity
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