原发性肝癌伴门静脉癌栓手术病人的预后因素

目的 :研究影响原发性肝癌伴门静脉癌栓手术病人预后的临床病理因素。方法 :随访 83例手术切除的原发性肝癌伴门静脉癌栓病人 ,其中 6 4例术后行门静脉和 (或 )肝动脉化疗栓塞。单因素分析各因素对生存率的影响。多因素分析用Cox风险比例模型。结果 :原发性肝癌伴门静脉癌栓单纯手术病人的中位生存时间 10 .3个月 ,若术后行各种化疗栓塞 ,病人的中位生存时间 13.4个月 ,其 1、2、3年生存率分别为 37.6 %、30 .7%、14 .0 % ,明显高于单纯手术组 (P <0 .0 5 )。单因素分析提示肿瘤大小、Edmondson分级、术后化疗栓塞次数是影响病人预后的主要因素。多因素分析提示Edmondson分级、术后化疗栓塞次数影响手术病人的预后。结论 :Edmondson分级、术后化疗栓塞次数是影响原发性肝癌伴门静脉癌栓手术病人预后的主要因素。术后门静脉和 (或 )肝动脉化疗栓塞可改善病人的预后

Prognostic Factors in Patients of Primary Liver Cancer with Portal Vein Tumor Thrombi after Surgical Treatment

Objective: To study the clinical and pathological factors affecting the prognosis in the patients of primary liver cancer (PLC) with portal vein tumor thrombi (PVTT). Methods: 83 patients of PLC with PVTT after surgical treatment were followed, in whom 64 patients were treated with chemoemblization after resection. The clinical and pathological factors affecting the survival were estimated by univariate and multivariate analysis. Results: The median survival time in the patients only treated with resection was 10.3 months. But in the patients treated with following chemoemblization the time was 13.4 months and the 1-, 2-,3-year survival rates were 53.7%, 37.6%, 30.7% and 14.0% respectively , which were significantly higher than the former (P<0.05). Both univariate analysis and multivariate analysis showed that cell differentiation and chemoemblization courses affected the prognosis. Conclusion:Cell differentiation and chemoemblization courses affected the prognosis in the patients of PLC with PVTT after resection. Chemoemblization may improve the suvivial.