目的：探讨经皮肝动脉化疗栓塞术（TACE）治疗后联合二期手术切除治疗BCLC-B期肝癌的意义。方法以TACE处理已丧失手术切除机会的BCLC-B期肝癌患者，有33例患者肿瘤缩小后获得二期手术切除肿瘤的机会，随访并分析其术后并发症，复发以及远期生存情况。结果33例中18例患者待手术时肿瘤缩小50%以上，15例待手术时肿瘤缩小30%～50%。联合二期手术切除术后1、3、5年生存率为83.6%、51.2%、34.7%，中位生存期39个月。结论 TACE并二期手术切除对提高BCLC-B期肝癌远期生存率具有一定的价值，是临床值得应用的治疗方法。%Objective To study the value of percutaneous transcatheter hepatic artery chemoembolization (TACE) in the treatment of stage BCLC-B hepatocellular carcinomaafter operation excision combined with second-stage operation. Methods The patients with HCC in stage BCLC-B who had lost the opporunity of surgical therapy been given TACE treatment.33 patients whose tumor shrink than before had the opportunity to have two stage operation. Follow-up and analysis of the postoperative complications,recurrence and long-term survival. Results In 18 patients of 30 patients participated in the experiment the tumor volume decreased more than 50%before operation.In the other 15 patients before operation the tumor volume was reduced from 30%to 50%. Combined with two postoperatively, 1, 3, 5 year survival rate was 83.6%, 51.2%and 34.7%, the median survival time was 39 months. Conclusion Combined two stage after TACE operation has certain value to improve the long-term survival rate of stage BCLC-B hepatocellular carcinoma, treatment method is worth of clinical application.
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