评价射频消融和手术切除治疗乳腺癌肝转移的疗效。

回顾性分析2010年1月至2014年5月在中山大学附属第三医院收治的15例乳腺癌肝转移患者临床资料。患者均为女性，年龄33～66岁，中位年龄49岁。所有患者均签署知情同意书，符合医学伦理学规定。根据不同治疗方案将患者分为射频消融+化疗组（消融组，9例）和手术+化疗组(手术组，6例)。观察两组围手术期情况并进行生存分析。围手术期观察数据比较采用t检验，率的比较采用Fisher确切概率法。生存分析采用Kaplan-Meier法和Log-rank检验。

消融组平均手术时间为（26±5） min，明显短于手术组的（151±27） min（t=-18.69，P<0.05）。消融组无术中输血情况，手术组术中输血3例。手术组肿瘤清除率为100%，消融组可获得与手术组一致的肿瘤清除率。消融组术后住院时间为（6±2）d，明显短于手术组的（11±5）d（t=-3.70，P<0.05）。消融组术后并发症发生率为4/9，明显低于手术组的5/6（P=0.02）。消融组和手术组的中位生存时间分别为33、23个月。消融组1、2、5年累积生存率分别为88.9%、66.7%、22.2%，手术组分别为82.3%、50.0%、0，两组比较差异无统计学意义（χ²=1.53，P>0.05）。

乳腺癌肝转移患者采用射频消融治疗可获得与手术切除治疗相同的疗效，且具有手术时间短、术后并发症发生率低、术后住院时间短的优势。

To evaluate the therapeutic effects of radiofrequency ablation and surgical resection for liver metastasis from breast cancer.

Clinical data of 15 patients with liver metastasis from breast cancer admitted and treated in the Third Affiliated Hospital of Sun Yat-sen University between January 2010 and May 2014 were retrospectively studied. All patients were females with the age ranging from 33 to 66 years old and the median of 49 years old. The informed consents of all patients were obtained and the local ethical committee approval had been received. According to the different therapeutic regimen, the patients were divided into radiofrequency ablation + chemotherapy group (ablation group, n=9) and surgery + chemotherapy group (surgery group, n=6). The conditions of two groups during the perioperative period were observed and the survival analysis was performed. The observations during perioperative period between two groups was compared using t test, the rates was compared using Fisher's exact test and the survival analysis was conducted using Kaplan-Meier method and Log-rank test.

The mean operation time of the ablation group was (26±5) min, which was significantly shorter than (151±27) min of the surgery group (t=-18.69, P<0.05). No case in the ablation group received blood transfusion while 3 cases in the surgery group received blood transfusion during the operation. The tumor clearance rate of the surgery group was 100%,which was the same with that of the ablation group. The postoperative hospital stay of the ablation group was (6±2) d, which was significantly shorter than (11±5) d of the surgery group (t=-3.70, P<0.05). The incidence of postoperative complications of the ablation group was 4/9, which was significantly lower than 5/6 of the surgery group (P=0.02). The median survival time of the ablation group and the surgery group was respectively 33, 23 months. The 1-, 2- and 5-year cumulative survival rate were respectively 88.9%, 66.7% and 22.2% for the ablation group and were respectively 82.3%, 50.0% and 0 for the surgery group and no significant difference was observed between two groups (χ²=1.53, P>0.05).

The radiofrequency ablation for patients with liver metastasis from breast cancer can have the same therapeutic effect with surgical resection, and has advantages of short operation time, low incidence of postoperative complications and short postoperative hospital stay.