| Primary liver cancer is one of the common malignant tumors in the world, The incidence rate of primary liver cancer is sixth, while the mortality rate is third. Due to the early symptoms of liver cancer patients are not typical, mostly in the middle and late stage once diagnosis and often delay the treatment at the best time, besides its high mortality rate, to the health of mankind has brought great challenges. Surgery is still the first choice for the treatment of liver cancer, but with the development of minimally invasive technology, its status has been the severe challenges of radiofrequency ablation. The aim of this study was to analyze the efficacy and safety of surgical resection and radiofrequency ablation in the treatment of primary liver cancer in Milan.This study review of 105 cases clinical data in 302 Military Hospital from December 2010 to July 2012 within milan criteria of primary liver cancer that received resection or radiofrequency ablation treatment, According to the standard of Milan, a group of(Single pure group) was divided into solitary tumors ranged from 3-5cm, Patients in this group were treated with simple surgical resection or radiofrequency ablation, and 73 cases were treated with a total of cases. The other group(Multiple combination group) was divided into multiple tumors less than or equal to 3 and is less than or equal to 3cm, this group of patients were treated with surgical resection combined with transcatheter arterial chemoembolisation(TACE) or TACE combined with radiofrequency ablation(RFA), a total of 32 cases. Two groups were respectively compared with postoperative survival rate of 1-, 2-, and 3-year, postoperative recurrence-free survival rate of 1-, 2-, and 3-year, complications, hospitalization days and the changes of liver function.Research results show that: 1. Surgical excision in 50 cases of single pure group, the postoperative survival rate of 1-, 2-, and 3-year were 86%, 78% and 58%, respectively; Radiofrequency ablation in 23 cases, postoperative survival rate of 1-, 2-, and 3-year were 73.9%、65.2%、17.4%, respectively, there were significant differences in the overall survival rate between the both(P<0.01). Operation combined with TACE treatment in 20 cases of multiple combination group, the postoperative survival rate of 1-, 2-, and 3-year were 90.0%、80.0%、60.0%, respectively; 12 cases were treated with TACE+RFA, postoperative survival rate of 1-, 2-, and 3-year were 91.7%、75.0%、16.7%, respectively(P=0.01). 2. The recurrence-free survival rate of 1-, 2-, and 3-year after operation in single pure group were 64%, 44% and 30%, respectively, recurrence-free survival rate of 1-, 2-, and 3-year after radiofrequency ablation were 43.5%、17.4%、0(P<0.01). The recurrence-free survival rate of 1-, 2-, and 3-year after operation combined with TACE in multiple combination group were 55%, 45%, 10%, respectively, recurrence-free survival rate of 1-, 2-, and 3-year after TACE+RFA were 41.7%, 16.7% and 0, respectively. 3. The incidence of complications of RFA or surgical treatment in single pure group were 34.8%(8/23) and 74%(37/50)(P < 0.01). The incidence of complications of TACE+RFA or operation combined with TACE in multiple combination group were 25%(3/12) 、 70%(14/20)(P=0.027). 4. ALT values were(267.68±229.20)IU/L、(110.57±70.84)IU/L(P<0.01) in the first day after surgical resection or RFA treatment in the single pure group; ALT values in the multiple combination group were(344.55±212.16)IU/L、(180.17±106.65)IU/L(P=0.019) in the first day after operation combined with TACE or TACE+RFA. 5. AFP was positive in 44 patients before treatment and 33 cases were effective after treatment in single pure group; AFP was positive in 18 cases of multiple combination group and 11 cases were effective after treatment.Conclusions of the study: 1. The primary liver cancer within milan criteria can benefit from surgery, and the long-term effect is better than that of radiofrequency ablation. 2. Radiofrequency ablation has little effect on liver function, less complications and other advantages, The therapy for preoperative liver function score Child B met the Milan criteria in patients with primary liver cancer is safe and effective. 3. Surgical resection and radiofrequency ablation can improve the positive value of AFP to some extent. |
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