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作 者:唐振宇[1] 王伟[2] 杜刚[1] 刘泽阳[1] 李佳[1] 张士哲 周兵海 靳斌[1]
机构地区:[1]山东大学齐鲁医院普外科,济南250012 [2]山东大学生物化学与分子生物学研究所
出 处:《中华肝胆外科杂志》2015年第1期18-22,共5页Chinese Journal of Hepatobiliary Surgery
基 金:国家自然科学基金(81100323)
摘 要:目的 比较原发性肝癌(HCC)合并门静脉癌栓(PVTT)不同治疗方法的疗效,探讨影响患者术后的预后因素.方法 回顾性分析我院2005年1月至2012年12月收治的539例HCC合并PVTT患者的临床资料.根据治疗方案的不同,将患者分为四组:保守治疗组(A组,47例)、单纯化疗组(B组,84例)、单纯手术组(C组,119例)、综合治疗组(D组,289例).结果 四组基线临床资料,包括肿瘤的数目、大小、门静脉癌栓分布等无明显差异(P>0.05).手术治疗及化疗均可提高患者的生存率,综合治疗有明显的优势.单因素、多因素分析提示肿瘤大小、肿瘤数目、门静脉癌栓分布及术后化疗次数是影响手术切除后疗效的危险因素.结论 对于HCC合并PVTT患者,积极手术治疗是有效的方法,术后联合化疗可提高患者的生存率.如患者病情可耐受,可行多次化疗栓塞.Objective To evaluate the efficacy of different therapeutic methods to treat primary hepatocellular carcinoma (HCC) with portal vein tumor thrombus (TVTT) and to clarify the prognostic factors affecting survival after therapy in a case-controlled study.Methods A retrospective study was carried out on 539 patients who underwent different treatments for HCC with PVTT at the Qilu Hospital of Shandong University from January 2005 to December 2012.The patients' clinical characteristics,tumor recurrence,and survival were analyzed.The patients were divided into four groups:(1) the conservative treatment group (group A,n =47) ; (2) the chemotherapy group (group B,n =84) ; (3) the surgical resection group (group C,n =119); (4) the surgical resection with postoperative chemotherapy group (group D,n =289).Results Analysis showed there were no significant differences among the four groups in the base-line clinical data which included the number of tumor,the size of tumor,and the state of PVTT (P 〉 0.05).Both surgical resection and chemotherapy improved the survival rates of patients,and comprehensive treatment was of better effect over surgical resection or chemotherapy alone.Univariate analysis and multivariate analysis revealed that the size of tumor,the number of tumor,the state of PVTT,the number of cycles of chemotherapy affected the prognosis.Conclusions Operative treatment was the most effective therapeutic strategy for HCC patients with PVTT.Surgical resection followed by postoperative chemotherapy increased the survival rate.If the patients' liver function allowed,multiple chemotherapeutic cycles should be given to improve the therapeutic efficacy.
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