射频消融、手术切除与肝动脉化疗栓塞术治疗原发性肝癌的对比分析文献综述

Literature Review of Comparative Analysis of Radiofrequency Ablation, Surgical Resection and Transcatheter Arterial Chemoembolization for the Treatment of Primary Hepatocellular Carcinoma

摘要: 原发性肝癌(HCC)是全球范围内发病率和死亡率均位居前列的恶性肿瘤之一，严重威胁人类健康。在我国，由于乙型肝炎病毒的高感染率等因素，肝癌的疾病负担尤为沉重。选择最优的治疗策略对于改善患者的生存预后、提高生活质量具有至关重要的意义。射频消融(RFA)、手术切除(LR)和肝动脉化疗栓塞术(TACE)是当前临床上治疗原发性肝癌，尤其是早中期肝癌的三种主要局部治疗手段。它们各自具有独特的适应症、技术特点、疗效以及伴随的风险。深入系统地对比分析这三种疗法的优劣、适应人群、并发症及长期生存结局，能为临床决策提供关键依据，实现治疗的个体化和精准化。本研究聚焦于此核心问题。文献资料来源于中国知网(CNKI)、万方数据等权威中文学术数据库，通过系统检索关键词“射频消融”、“手术切除”、“肝动脉化疗栓塞术”、“肝癌”、“对比”、“疗效”、“预后”、“复发”等进行搜集，并限定文献类型为期刊论文和学位论文。初步筛选后，共获得具有直接相关性的有效文献22篇，其中包括多篇高质量的Meta分析、大样本临床对比研究和详尽的综述，这些文献为本研究对比分析三种疗法的有效性、安全性及预后因素奠定了坚实的证据基础。

Abstract: Primary hepatocellular carcinoma (HCC), one of the most prevalent malignant tumors globally in terms of both incidence and mortality, poses a significant threat to human health. In China, the disease burden of liver cancer is particularly heavy due to factors such as high hepatitis B virus infection rates. Selecting optimal treatment strategies is crucial for improving patient survival prognosis and quality of life. Radiofrequency ablation (RFA), liver surgical resection (LR), and transcatheter arterial chemoembolization (TACE) are currently the three main local treatment approaches for primary HCC, especially in early and intermediate stages of liver cancer. Each has unique indications, technical characteristics, therapeutic effects, and associated risks. A systematic comparative analysis of these three therapies’ advantages and disadvantages, target populations, complications, and long-term survival outcomes can provide critical evidence for clinical decision-making, enabling personalized and precise treatment. This study focuses on this core issue. Literature sources include authoritative Chinese academic databases such as China National Knowledge Infrastructure (CNKI) and Wanfang Data. Through systematic searches using keywords like “radiofrequency ablation”, “surgical resection”, “transcatheter arterial chemoembolization”, “liver cancer”, “comparison”, “therapeutic efficacy”, “prognosis”, and “recurrence”, with the literature type restricted to journal articles and theses, we identified 22 relevant studies including high-quality Meta-analyses, large-scale clinical comparative studies, and detailed reviews. These studies form the solid evidential foundation for this study’s comparative analysis of the efficacy, safety, and prognostic factors of the three therapies.