术后肝动脉化疗栓塞对提高肝细胞癌术后无瘤生存率的意义

目的　评价术后采用肝动脉化疗栓塞 (TACE)对提高肝细胞癌患者术后无瘤生存率的价值。　方法　对 172 5例行肝细胞癌切除术的患者进行回顾性随访 ,资料完整者 14 5 7例 ,其中 2 0 9例术后行TACE。对肿瘤子灶、血管侵犯、肿瘤包膜完整、小肝癌 (≤ 5 0cm)和肝硬化与否 10个因素分组 ,每组再按术后是否行TACE分别进行无瘤生存分析。采用SAS 6 12和EGRET软件 ,以Kaplan Meier法计算无瘤生存率 ,χ2 检验进行显著性差异检验。　结果　肿瘤包膜完整和无肝硬化 2组术后行TACE与未行TACE的无瘤生存率比较差异无显著意义 (χ2 =2 34,χ2 =0 0 6 ,P >0 0 5 )。其他 8个因素组中术后有无行TACE间生存率比较 ,差异有显著意义 ,P值均 <0 0 5。予TACE者无瘤生存率明显高于未行者。　结论　除病理结果提示肿瘤包膜完整和无肝硬化的患者之外 ,肝切除术后给予TACE将有助于提高患者术后的无瘤生存率 ,对提高手术疗效具有重要意义

The effect of postoperative transcatheter hepatic arterial chemoembolization on disease-free survival after hepatectomy for hepatocellular carcinoma

Objective To evaluate postoperative transcatheter hepatic arterial chemoembolization (TACE) for improving the disease free survival of HCC patients after hepatectomy. Methods 1 725 HCC patients were followed up after hepatectomy retrospectively. Of 1 457 patients who were followed up completely, 209 had postoperative TACE. The 1 457 patients were divided into ten groups according to tumor thrombus, small HCC, capsular invasion, vescular invasion and cirrosis. The disease free survival was analyzed between subgroups of weather postoperative TACE was performed in every group. Software SAS 6 12 and EGRET package were used. Kaplan Meier estimation was used to calculate the disease free survival rates. Results There were no difference of the disease free survival between the subgroups in no capsular invasion and in no hepatic cirrhosis groups. Conclusion Postoperative TACE is helpful in improving the disease free survival of HCC patients after hepatectomy except those with integrated tumor envelope or no hepatocirrhosis. It is important to prolong the long term results of operation.