肝动脉化疗栓塞对原发性肝癌伴门静脉癌栓的治疗作用

目的:研究肝动脉化疗栓塞(HACE)对原发性肝癌伴门静脉癌栓的治疗作用及影响患者预后的临床病理因素。方法:随访35例HACE治疗的原发性肝癌伴门静脉癌栓患者,其中14例患者经导管肝动脉化疗栓塞,21例患者术中行肝动脉插管,术后经药物泵定期化疗栓塞。单因素分析各临床病理因素对患者预后的影响。多因素分析用Cox比例风险模型。结果:原发性肝癌伴门静脉癌栓行HACE治疗的患者中位生存时间8·3个月,其半年、1和2年生存率分别为57·5%、15·7%和0。单因素分析提示门静脉癌栓部位、化疗栓塞次数是影响患者预后的主要因素。多因素分析仅提示门静脉癌栓部位影响患者的预后。结论:HACE治疗原发性肝癌伴门静脉癌栓可以延长患者的生存期。门静脉癌栓的部位是影响患者预后的独立因素。

Therapeutic effects of hepatic artery chemoembolization in primary liver cancer patients with tumor thrombi in portal vein

OBJECTIVE:To study the effects of HACE (hepatic artery chemoembolization) and evaluate the factors affecting the prognosis in primary liver cancer patients with tumor thrombi in portal vein. METHODS: A total of 35 patients treated by HACE were followed, including 14 patients treated by transcatheter artery chemoemblization, 21 patients treated by hepatic artery infusion (HAI) with postoperative chemoembolization. The factors affecting the prognosis of patients were estimated by univariate and multivariate analysis. RESULTS: The median survival period of patients was 8.3 months and the half-year-, 1-year, 2-year survival rates were 57.5%, 15.7% and 0, respectively. Both univariate and multivariate analysis showed that the location of tumor thrombi in portal vein affected the prognosis of patients. CONCLUSIONS: HACE prolongs the life span in primary liver cancer patients with tumor thrombi in portal vein. The location of tumor thrombi in portal vein is an independent prognostic factor.