肝动脉化疗栓塞治疗5 cm以下肝癌的疗效及预后因素

目的研究肝动脉化疗栓塞(TACE)治疗直径＜5 cm肝癌的效果以及预后因素.方法对1995年2月～2004年2月间肝动脉化疗栓塞治疗的直径＜5 cm的原发性肝癌患者160例的效果进行回顾性分析,log-rank方法单因素分析影响预后的因素,多因素分析采用Cox比例风险模型确定独立的危险因素.结果肝动脉化疗栓塞后的1年、3年、5年生存率分别为77.52%、47.42%、33.68%.血清胆红素水平＞17.0μmol/L、凝血酶原时间超过14 s、有门静脉癌栓和有远处转移是影响预后的独立的危险因素.结论对于手术不能切除的直径＜5 cm的肝癌,肝动脉化疗栓塞是可供选择的有效治疗方法,但有血清胆红素升高或凝血酶原延长的病人,或有门静脉癌栓和远处转移的病人,预后较差.

The efficacy and prognostic factors of transcatheter arterial chemoembolization for the use of the patients with primary liver cancer which diameter is 5 cm or less

Objective: To evaluate the therapeutic efficacy and to identify the prognostic factors of transcatheter arterial chemoembolization (TACE) in the patients with primary liver cancer which diameter is 5 cm or less. Methods From Feb 1995 to Feb 2004, we retrospectively studied the outcome of 160 primary liver cancer patients who had undergone TACE. The log-rank method was used for univariate analysis and the Cox proportional hazard model was used for multivariate analysis for prognostic factors. Results The 1-, 3-, and 5-year survival rates were 77. 52% , 47. 42% and 33. 68%, respectively. The elevated serum total bilirubin, the prolonged prothrombin time, presence of the cancerous thrombi in portal vein and the distant metastasis were independent factors for poor prognosis after TACE treatment. Conclusion TACE is an effective alternative therapy for unresect-able primary liver cancer patients above. However, poor prognosis should be considered in the patients with abnormal liver functions, especially elevated serum total bilirubin and prolonged prothrombin time and with cancerous thrombi in portal vein and distant metastases.