肝细胞肝癌并肝静脉癌栓外科手术治疗远期随访评价  

Long-term follow-up evaluation of surgical treatment of 30 cases of hepatocellular carcinoma with hepatic vein tumor thrombus

作　　者：余伟华[1] 范耀刚 王义刚[1] 杨楷 栗粟[1] Yu Weihua;Fan Yaogang;Wang Yigang;Yang Kai;Li Su(Department of Hepatobiliary Surgery,Panzhihua Central Hospital,Sichuan 617067,China)

机构地区：[1]四川省攀枝花市中心医院肝胆外科,617067

出　　处：《中华普外科手术学杂志（电子版）》2021年第4期388-391,共4页Chinese Journal of Operative Procedures of General Surgery(Electronic Edition)

基　　金：四川省卫生和计划生育委员会项目(16PJ218)。

摘　　要：目的探究外科手术治疗肝细胞肝癌并肝静脉癌栓的远期疗效。方法回顾性分析2013年1月至2015年12月82例肝细胞肝癌并肝静脉癌栓患者的临床资料,按不同治疗方式将采用外科手术治疗的30例患者纳入手术组,将采用肝动脉灌注化疗栓塞术(TACE)治疗的52例患者纳入TACE组。采用SPSS23.0软件进行处理,GQOLI-74评分以(x±s)表示,独立t检验;临床疗效采用秩和检验;并发症发生率及肿瘤复发率采用χ^(2)检验;生存率采用Kaplan-meier法检验。P<0.05为差异有统计学意义。结果手术组治疗有效率(83.3%)及GQOLI-74评分高于TACE组(61.5%),差异有统计学意义(P<0.05);手术组1年、3年生存率高于TACE组,1年肿瘤复发率低于TACE组(P<0.05);两组并发症发生率、5年生存率及3年、5年肿瘤复发率比较,差异无统计学意义(P>0.05)。结论外科手术治疗肝细胞肝癌并肝静脉癌栓疗效良好,可提高患者远期预后,改善生活质量,且与TACE术后并发症风险均较低。Objective To analyze the long-term clinical outcome of surgical treatment of hepatocellular carcinoma with hepatic vein tumor thrombus.Methods The clinical data of 82 patients with hepatocellular carcinoma with hepatic vein tumor thrombus from January 2013 to December 2015 were analyzed retrospectively.According to different treatment methods,30 patients who underwent surgical treatment were enrolled into the operation group,52 patients treated with hepatic artery infusion chemotherapy(TACE)were enrolled into the TACE group.SPSS23.0 software were used for processing the data,and the GQOLI-74 score was expressed as (x±s),and was examined by using independent t test;the clinical outcome were examined by using rank sum test;the incidence of complications and the tumor recurrence rate were examined byχ^(2) test;while the survival rate was analyzed by using Kaplan-meier method.A P value of<0.05 was considered as statistically significant difference.Results The effective rate of treatment and GQOLI-74 score in the operation group were significantly higher than that in the TACE group(83.3%vs.61.5%,P<0.05);the 1/3-year survival rate of operation group was higher than those of the TACE group,while the tumor recurrence rate was lower than that of the TACE group(P<0.05);There were no significant difference of complication rate,5-year survival rate and 3/5-year recurrence rate between two groups(P>0.05).Conclusion Surgical treatment of hepatocellular carcinoma with hepatic vein tumor thrombus has a good effect,could improve the long-term prognosis of patients and the quality of life,while the risk of complications after TACE is relatively lower.

关 键 词：癌 肝细胞 肝静脉 肝静脉癌栓 外科手术 存活率分析 肝动脉化疗栓塞术 

分 类 号：R73[医药卫生—肿瘤]