肝癌术后预防性肝动脉化疗栓塞对延缓复发的意义

目的]了解预防性肝动脉化疗栓塞术(TACE)在延缓肝癌手术后复发方面的作用.方法]对823例行根治性切除并经病理证实为肝细胞癌患者进行随访分析.其中126例患者手术后行预防性TACE,将可能影响原发性肝癌术后复发的观察指标包括性别、年龄、术前AFP、有无癌栓、手术切缘、手术前肿瘤是否破裂、肿瘤大小、肿瘤有无子灶、肿瘤包膜情况、手术后有无行预防性TACE等,用Cox模型分析各因素与复发时间之间的关系.所有数据经SAS6.12和SPSS统计软件处理分析.结果]年龄小、有癌栓、手术前肿瘤有破裂、肿瘤体积大和肿瘤周围有子灶等因素使肝癌手术后复发时间提前,保证较大手术切缘距离和手术后行预防性TACE可延缓肝癌手术后复发.预防性TACE可明显降低肝癌患者术后2年的复发率.结论]对有早期复发病理学征象的肝癌患者行预防性TACE治疗可能延缓术后肿瘤复发.

Effect of Postoperative Prophylactic Transcatheter Arterial Chemoembolization on Delaying Recurrence in Patients with Hepatocellular Carcinoma

To investigate effect of postoperative prophylactic transcatheter arterial chemoembolization(TACE)on delaying recurrence in patients with hepatocellular carcinoma(HCC).Eight hundred amd twenty-three patients with HCC pathologically proved who accepted radical resection were followed up,126 patients underwent prophylactic TACE after operation.Clinical and pathological factors such as gender,age,preoperative alpha-fetoprotein (AFP),tumor thrombus,surgical margin, tumor rupture, diameter of main nodule, number of nodules, tumor capsule, prophylactic TACE ,etc were analyzed by Cox model.The data were analyzed by software of SAS6.12 and SPSS.Younger patients, present of tumor thrombus,tumor rupture,larger tumors and present of tumor daughters significantly decreased disease-free survival rate.Safely surgical margin greater than 2 cm and prophylactic TACE significantly increased the disease-free survival rate.Prophylactic TACE could significantly increase the 2-year disease-free survival rate after operation.Conclusions]Patient with high risk to recurrence should be candidate for prophylactic TACE to delay recurrence.