术前TACE对肝细胞肝癌患者肝切除术后预后的影响

目的：探讨术前经肝动脉化疗栓塞术（TACE）对肝细胞肝癌（HCC）肝切除患者生存及预后的影响。方法：对479例行肝切除并经病理确诊、临床资料完整的HCC患者进行回顾性分析,除外失访及死亡者50例,余按TACE时机分为2组,其中术前TACE组50例,术前无TACE组379例。对2组患者的临床病理资料行χ2检验,Kaplan-Meier分析术后无瘤生存率及预后。结果：术前2组患者在性别、病灶数目、肿瘤最大径、AFP、HBV感染、静脉癌栓、肝切除范围及肝硬化等方面差异均无统计学意义（P〉0.05）。但术前TACE组患者年龄比术前无TACE组小（χ2=6.228,P=0.012）,且肿瘤分化程度低、坏死率高（χ2=53.874,P=0.000）。2组患者无瘤生存率及总体生存率差异均无统计学意义（χ2=0.736,P=0.391;χ2=0.000,P=0.995）。结论：不能一期切除的肝细胞肝癌患者,经TACE后行手术治疗,其无瘤生存率及预后与直接手术相似。

Efficiency of preoperative TACE treatment to HCC patients after hepatectomy

Objective： To study the efficiency and prognosis of preoperative transcatheter arterial chemoembolization（TACE）treatment in patients with hepatocellular carcinoma（HCC）after hepatectomy. Methods： The clinical pathological data of 479 patients with resectable HCC from 1998 to 2007 were analyzed retrospectively. Fifty patients had preoperative TACE, 379 cases had not and others were lost of follow up or dead. Clinical pathological data, tumor-free survival rate and overall survival rate after hepatectomy were analyzed. Results： There was a significantly difference in the age and the tumor grade between the groups, other clinical pathological factors were no difference. The preoperative TACE group was younger than non-TACE group （χ2=6.228, P=0.012）, And had lower tu-mor grade, more tumor necrosis （χ2=53.874, P=0.000）. The disease tumor-free survival rate and overall survival rate were no difference between the groups （χ2=0.736, P=0.391;χ2=0.000, P=0. 995）. Conclusions： For the unresectable HCC patients by one-stage operation, the preoperative TACE treatment has no adverse effect. However, tumor-free survival rate and overall survival rate are similar to non-TACE group.