肿瘤切除前 TACE 对巴塞罗那临床肝癌分期B 期患者预后的影响

摘要

Objective To investigate the effect of preoperative transarterial chemoembolization ( TACE) on the prog-nosis of stage B hepatocellular carcinoma (HCC) in the Barcelona Clinic Liver Cancer (BCLC) classification.Methods A total of 309 stage B hepatocellular carcinoma patients treated with hepatectomy were enrolled in our retrospective analy -sis, among whom, 136 patients underwent preoperative TACE and hepatectomy (TACE group) and 173 patients had only hepatectomy (non-TACE group).Independent-Samples t-test and Pearson χ2 test were used to analyze the clinical data of the two groups.Long-rank test and Cox regression models were used to compare the overall survival rates .Results There were no significant differences in clinical data between the two groups (P>0.05).The median survival time was 36 and 26 months for the TACE group and non-TACE group, respectively (χ2 =9.226, P<0.05).In the Long-rank univariate anal-ysis, different treatments, diameter of tumor, surgical margin status and the level of serum AFP were risk factors in influen-cing the survival HCC patients (P<0.05).Cox multivariate analysis showed that different treatment was an independent factor in affecting the prognosis of HCC patients (RR:1.576, 95%CI:1.157-2.146, P=0.004).Conclusion Pre-operative adjuvant TACE therapy may prolong the survival time in BCLC stage B HCC patients treated with hepatectomy .%目的：探讨肿瘤切除术前行经皮股动脉穿刺肝动脉化疗栓塞术（TACE）对巴塞罗那临床肝癌（BCLC）分期B期患者预后的影响。方法对309例首次行肝癌切除术的BCLC分期B期患者的临床资料进行回顾性分析，根据术前是否行TACE分为联合组和手术组，用两独立样本t检验和Pearson χ2检验比较两组一般临床资料，用Log-rank检验和Cox比例风险回归模型比较两组生存率。结果两组一般临床资料无统计学差异（ P＞0．05）；联合组和手术组中位生存期分别为36、26个月，组间比较P＜0．05（χ2＝9．226）；治疗方式、肿瘤直径、手术切缘和血清AFP水平是影响患者生存率的危险因素（P＜0．05），且治疗方式是影响患者预后的独立危险因素（RR为1．576，95％CI为1．157～2．146， P＝0．004）。结论对于BCLC分期B期患者，在切除术前给予辅助性TACE治疗有望延长术后生存时间。