辅助性肝动脉化疗栓塞术对原发性肝癌切除手术预后的影响  

Effect of postoperative adjuvant transarterial chemoembolization on prognosis of patients after radical resection of primary hepatocellular carcinoma

作　　者：刘小瑜[1] 苏子剑[1] 王聪仁[1] 潘群雄[1] 

机构地区：[1]福建医科大学附属泉州第一医院N4区肿瘤外科,362000

出　　处：《中华肝胆外科杂志》2015年第1期23-28,共6页Chinese Journal of Hepatobiliary Surgery

基　　金：福建省自然科学基金（2014J01435）

摘　　要：目的 研究辅助性肝动脉化疗栓塞（TACE）对原发性肝癌切除术后患者预后的影响,为临床评估术后合理选择辅助性TACE提供参考.方法 回顾性分析福建医科大学附属泉州第一医院2002-2008年311例原发性肝癌患者的临床资料.利用COX回归模型逐步分析,Kaplan-Meier法分析辅助性TACE对肿瘤直径≤5 cm高危组（76例）、低危组（91例）以及肿瘤直径＞5 cm高危组（65例）、低危组（78例）患者预后的影响.低危组定义为肿瘤单发且无血管侵犯;高危组定义为肿瘤多发和（或）血管侵犯.结果 在肿瘤直径＞5 cm高危组,术后行辅助性TACE者总生存期高于术后未行辅助性TACE者（P＜0.05）.其他亚组术后是否行辅助性TACE对总生存期无明显影响（P＞0.05）.结论 辅助性TACE对于肿瘤直径＞5 cm的高危组肝癌术后患者是有受益的.Objective To study the effect of postoperative adjuvant transarterial chemoembolization （TACE） on prognosis of patients after radical resection of primary hepatocellular carcinoma.Methods A retrospective analysis was conducted on 311 patients with primary hepatocellular carcinoma treated from 2002 to 2008 in Quanzhou First Hospital affiliated to the Fujian Medical University.Utilizing the COX regression model and the Kaplan-Meier analysis,the effects of adjuvant TACE on prognosis of both the high risk group （n =76） and the low risk group （n =91） with tumor ≤5 cm,as well as both the high risk group （n =65） and the low risk group （n =78） with tumor 〉 5 cm were determined.The low risk group was defined as patients with a single tumor and without vascular invasion,while the high risk group was defined as patients with multiple tumors or with vascular invasion.Results The postoperative overall survival rate of the high risk group who underwent postoperative adjuvant TACE with tumor 〉 5 cm was higher than that of the high risk group who did not undergo postoperative adjuvant TACE （P 〈 0.05）.However,whether or not postoperative adjuvant TACE was given had no effect on prognosis in the other subgroups of patients （P 〉 0.05）.Conclusion Postoperative adjuvant TACE was beneficial to the high risk group of patients with tumor 〉 5 cm after radical resection of primary hepatocellular carcinoma.

关 键 词：肝细胞 癌 肝动脉化疗栓塞 

分 类 号：R735.7[医药卫生—肿瘤]