肝切除联合微波固化治疗BCLC-B期肝细胞癌的生存预后分析  

Survival of BCLC-B hepatocellular carcinoma patients after liver resection combined with microwave coagulation therapy vs transarterial chemoembolization

作　　者：杨振宇[1] 杜锡林[1] 雷世雄 谭凯[1] 杨涛[1] 鲁建国[1] 

机构地区：[1]第四军医大学唐都医院普通外科,西安710038

出　　处：《中华普通外科杂志》2017年第5期381-385,共5页Chinese Journal of General Surgery

基　　金：国家自然科学基金面上基金资助项目（81172287）

摘　　要：目的探讨肝切除联合术中微波固化或经导管肝动脉栓塞（transcatheter arterial chemoembolization，TACE）对BCLC—B期肝细胞癌患者生存预后的影响。方法回顾性分析172例BCLC．B期患者资料，分为2组，分别接受手术联合微波固化（liver resection combined with microwave coagulation therapy，LR＋MCT）组，107例及接受TACE治疗组，65例。分别比较2组患者术后30d的死亡率、中位生存期、近远期生存率及并发症等。结果2组患者院内死亡率比较差异无统计学意义（χ2=0．285，P=0．593），但LR＋MCT组术后有更高的并发症发生率（χ2=4．694，P：0．03）。LR＋MCT组比TACE组的总体中位生存期长，差异有统计学意义（r=9．135，P=0．003），但2组5年生存期差异无统计学意义（χ2=4．767，P=0．434）。结论微波固化联合肝切除术和TACE是一样安全，并且手术组能够获得更长的中位生存期和较高的早期生存率。Objective To explore the prognosis of patients with BCLC-B hepatocellular carcinoma （HCC） receiving LR ＋ MCT vs TACE. Methods BCLC-B HCC patients undergoing LR ＋ MCT （ 107 cases） and TACE （65 cases） were retrospectively evaluated, in terms of 30-day mortality rate, the median survival, early and long term survival rate and complications. Results The hospital mortality rate was similar between the two groups （χ2 = 0. 285, P = 0. 593 ）. However, the LR ＋ MCT group were with a significantly higher postoperative complication rate than the TACE group （χ2 = 4. 694, P = 0.03 ）. At the same time, the LR ＋ MET group had significantly higher median survival rates （χ2 = 9. 135, P = 0. 003 ）, but, there was no statistical difference for five-year survival （χ2 = 4. 767, P = 0. 434 ）. Conclusions LR ＋ MCT are as safe as TACE for patients with BCLC-B HCC, and it provides longer median survival rates.

关 键 词：癌 肝细胞 微波 化学疗法 肿瘤 局部灌注 

分 类 号：R735.7[医药卫生—肿瘤]