术后辅助肝动脉化疗栓塞对巨块型肝癌根治性切除术后生存的影响

目的:探讨巨块型肝癌根治性切除术后行辅助性经导管肝动脉化疗栓塞(transeatheter hepatic arterial chemo-embolization,TACE)治疗对术后生存的影响.方法:回顾性收集256例资料完整的巨块型肝癌患者,这些患者均接受了手术切除.其中136例患者于术后4～6周接受辅助性TACE治疗,另120例患者仅接受单纯手术切除.根据是否伴有残癌高危因素(子灶、门静脉二级分支以上的癌栓和包膜不完整)对所有患者进行分层分析,比较各组患者的术后生存率.结果:对于不伴有残癌高危因素的巨块型肝癌,术后辅助TACE组与单纯手术切除组的1、3、5年生存率分别为80.43%、59.92%、47.18%与74.05%、53.40%、45.77%,2组的生存率比较差异无统计学意义(P=0.769 3).对于伴有残癌高危因素的巨块型肝癌,术后辅助TACE组与单纯手术切除组的1、3、5年生存率分别为72.15%、32.27%、22.35%与45.36%、22.47%、19.67%,2组的生存率比较差异有统计学意义(P=0.004 9).COX回归分析表明,术后辅助TACE治疗风险比(hazard ratio,HR)=0.620(95%的可信区间为0.441～0.870)]和残癌高危因素HR=2.235(95%的可信区间为1.491～3.351)]是影响巨块型肝癌患者术后长期生存的独立危险因素.结论:巨块型肝癌患者术后行辅助性TACE治疗有助于提高术后的长期生存率,而其中伴有残癌高危因素的患者,其术后生存时间的延长更为明显.

The effect of postoperative adjuvant transcatheter hepatic arterial chemoembolization on survival of patients after resection of huge hepatocellular carcinoma

Objective: To investigate the efficacy of postoperative transcatheter arterial chemoembolization(TACE) on survival of patients after resection of huge hepatocellular carcinoma.Methods: This study retrospectively collected the clinical data of 256 huge hepatocellular carcinoma patients who had received radical resection.Among them 136 patients received postoperative adjuvant TACE 4-6 weeks post resection,and the other 120 patients received surgical resection only.Stratification analysis was performed on all ...