TACE治疗巨大肝癌60例疗效及预后因素分析  

Predictors of survival after chemoembolization of huge hepatocellular carcinoma-α series of 60 cases

作　　者：杨列永[1] 任正刚[1] 叶胜龙[1] 乐凡[1] 张岚[1] 杨毕伟[1] 夏景林[1] 干育红[1] 王艳红[1] 张博恒[1] 

机构地区：[1]复旦大学附属中山医院肝肿瘤内科,上海200032

出　　处：《中华肿瘤防治杂志》2007年第22期1734-1735,共2页Chinese Journal of Cancer Prevention and Treatment

摘　　要：为了研究肝动脉化疗栓塞(transcatheter arterial chemoembolization,TACE)治疗巨大原发性肝癌的效果及预后因素,对1998年9月～2004年12月TACE治疗的直径≥100mm的60例原发性肝癌患者的临床资料进行回顾分析,log-rank单因素分析影响预后的因素,多因素分析采用cox比例风险模型确定独立的危险因素。结果显示TACE治疗后的1年、2年、3年生存率分别为41.7%、14.7%和7.3%。Child-pugh分级、有无门脉栓子、TACE术后4d白蛋白下降程度是影响预后的独立因素。TACE治疗巨大肝癌的疗效尚不令人满意,应用大剂量碘油不能提高巨大肝癌患者的生存时间,有门静脉栓子和肝脏储备功能差的患者手术后的预后较差。The objective of this study was to investigate the efficacy of chemoembolization in the treatment of huge HCC and analyze the survival predictors. From September 1998 to December 2004, a series of sixty pathologically confirmed HCC patients with a diameter of 10 cm or larger treated with TACE were retrospectively studied. Log-rank univariable analysis and Cox regression analysis were performed to determine the predictors of survival. The 1-, 2- and 3- year survival rates of the patients with huge HCC after TACE were 41.7%, 14.7% and 7.3%, respectively. High Child-pugh scores, existence of portal vein thrombi and drastic decrease of serum albumin after the first TACE were the factors predicting poor survival independently. In conclusion, TACE is not very effective in subset of patients with huge HCC. Increased lipiodol dosage is not related to longer survive and those patients with poor liver function reservation are of poor survival period as expected.

关 键 词：肝肿瘤/治疗 栓塞 治疗性 预后 

分 类 号：R735.7[医药卫生—肿瘤]