ABSTRACT
Objective To compare the clinical effect of microwave ablation and surgical resection in the treatment of primary liver cancer.Methods A total of 76 patients with primary liver cancer were selected from May 2010 to June 2012 in the Fourth People's Hospital of Shangqiu City.The patients were divided into microwave ablation group (n =46) and hepatectomy group (n =30) according to the treatment.The operation time,blood loss,hospitalization time,the levels of serum alanine aminotransferase (ALT) and total bilirubin (TBIL) before and after operation,and postoperative complications were compared between the two groups.All patients were followed up for five years,and the disease-free survival rates of 1-,3-and 5-year were observed and compared between the two groups.Results The operation time and hospitalization time in the microwave ablation group were significantly shorter than those in the hepatectomy group (P ＜ 0.05),and the intraoperative blood loss in the microwave ablation group was significantly less than that in the hepatectomy group (P ＜ 0.05).There was no significant difference in the levels of serum ALT and TBIL between the two groups before operation (P ＞ 0.05).The levels of serum ALT and TBIL at the time points of one day and one week after operation were significantly higher than those before operation in the hepatectomy group (P ＜ 0.05).There was no significant differences in the levels of serum ALT and TBIL in the microwave ablation group between before operation and one day or one week after operation (P ＞ 0.05).The levels of serum ALT and TBIL in the microwave ablation group were significantly lower than those in the hepatectomy group at the time points of one day and one week after operation (P ＜ 0.05).The incidence of postoperative complication in the microwave ablation group and the hepatectomy group was 4.35％ (2/46) and 23.33％ (7/30) respectively,the incidence of postoperative complication in the microwave ablation group was significantly lower than that in the hepatectomy group (x2 =6.269,P ＜ 0.05).The disease-free survival rate of 1-,3-and 5-year was 67.39％ (31/46),39.13％ (18/46) and 28.26％ (13/46) respectively;and the tumor recurrence rate was 54.35％ (25/46) in the microwave ablation group.The disease-free survival rate of 1-,3-and 5-year was 70.00％ (21/30),50.00％ (15/30) and 33.33％ (10/30) respectively;and the tumor recurrence rate was 50.00％ (15/30) in the hepatectomy group.There was no significant difference in the disease-free survival rate of 1-,3-and 5-year and tumor recurrence rate between the two groups (P ＞ 0.05).Conclusion Microwave ablation therapy in the treatment of primary liver cancer has less trauma,less intraoperative blood loss,shorter hospitalization time,the lower incidence of postoperative complication,high safety and feasibility.Microwave ablation can better protect the liver function of patients.Microwave ablation and hepatectomy for primary liver cancer can achieve the similar disease-free survival rate and tumor recurrence rate.