PVCE联合TACE预防肝癌切除术后复发的临床分析

目的：探讨门静脉化疗栓塞（PVCE）联合肝动脉化疗栓塞（TACE）对预防原发性肝癌切除术后复发的价值。方法：回顾性分析2008年1月-2011年12月71例肝癌手术切除患者的临床资料。其中，术后PVCE联合TACE组37例，单纯TACE组34例。对术后肿瘤复发情况进行随访，应用Kaplan—Meier方法分析2组累积无瘤生存时间，采用COX比例风险模型进行多因素分析，筛选出独立预后因素。结果：PVCE联合TACE组和单纯TACE组术后中位无瘤生存期分别为21．1个月和18．6个月，PVCE联合TACE组累积无瘤生存时间明显高于单纯TACE组（P〈O001）。Cox模型多因素分析显示，肿瘤大小、门静脉癌栓、肿瘤分化程度是影响肝癌患者切除术后复发的独立因素。结论：肝癌切除术后联合PVCE和TACE更能延长患者术后复发时间。

Clinical analysis of portal vein chemoembolization and transcatheter arterial chemoembolization on prevention of recurrence after resection of hepatic carcinoma

Objective： To explore the value of portal vein chemoembolization（PVCE） and tran- scatheter arterial chemoembolization （TACE） on the prevention of recurrence after resection of pri- mary hepatic carcinoma. Methods： The clinical data of 71 patients who received liver resection forhepatic carcinoma from January 2008 to December 2011 were studied retrospectively. After opera- tion, PVCE in combination with TACE was performed in 37 patients （the treatment group）, TACE alone in 34 （the control group）. Cumulative disease free survivals were compared using the Ka- plan-Meier method, Results： The median disease free survivals were 21.1 months and 18.6 months respectively. The cumulative disease free survivals in the treatment group were significantly higher than the control group（P〈0.001）. Cox multivariate analysis showed that tumor size, portal vein thrombosis and the tumor differentiation grade were independent factors of disease free survival. Conclusion： For primary hepatic carcinoma,after hepatectomy, using portal vein chemoemboliza- tion with transcatheter arterial chemoembolization could delay the time of recurrence than transarte- rial che moembolization alone.