CAJ | 학술논문

目的探讨原发性肝细胞癌切除术后,经皮经肝门静脉穿刺化疗栓塞(PVCE)预防肿瘤复发的效果.方法回顾性分析我院2007年1月至2010年1月89例肝癌手术切除患者临床资料.其中术后进行预防性经皮经肝门静脉穿刺化疗栓塞(治疗组)41例,未行预防性门静脉化疗栓塞(对照组)48例.随访术后肿瘤复发情况,应用Kaplan-Meier方法分析两组累积无瘤生存率.组间比较用对数秩检验.采用Cox风险比例模型进行多因素分析,筛选出独立预后因素.结果术后随访6～42个月.治疗组患者术后1年及2年无瘤生存率分别为76.5％、48.0％,对照组分别为53.8％、25.8％,差异有统计学意义(P＜0.05)；平均无瘤生存期分别为19.91个月(95％CI,16.09～23.73)和13.80个月(95％ CI,10.95～16.65),治疗组累积无瘤生存率高于对照组(P=0.01).Cox模型多因素分析显示:预防性门静脉化疗栓塞、肿瘤大小、术前门静脉癌栓、术后经导管动脉化疗栓塞(TACE)是影响患者肝癌切除术后复发的独立因素.结论肝癌切除术后经皮经肝门静脉穿刺化疗栓塞能有效预防肿瘤复发.
목적 탐토원발성간세포암절제술후,경피경간문정맥천자화료전새(PVCE)예방종류복발적효과.방법 회고성분석아원2007년1월지2010년1월89례간암수술절제환자림상자료.기중술후진행예방성경피경간문정맥천자화료전새(치료조)41례,미행예방성문정맥화료전새(대조조)48례.수방술후종류복발정황,응용Kaplan-Meier방법분석량조루적무류생존솔.조간비교용대수질검험.채용Cox풍험비례모형진행다인소분석,사선출독립예후인소.결과 술후수방6～42개월.치료조환자술후1년급2년무류생존솔분별위76.5％、48.0％,대조조분별위53.8％、25.8％,차이유통계학의의(P＜0.05)；평균무류생존기분별위19.91개월(95％CI,16.09～23.73)화13.80개월(95％ CI,10.95～16.65),치료조루적무류생존솔고우대조조(P=0.01).Cox모형다인소분석현시:예방성문정맥화료전새、종류대소、술전문정맥암전、술후경도관동맥화료전새(TACE)시영향환자간암절제술후복발적독립인소.결론 간암절제술후경피경간문정맥천자화료전새능유효예방종류복발.
Objective To study the efficacy of adjuvant percutaneous transhepatic portal vein chemoembolization (PVCE) in the prevention of tumor recurrence after partial hepatectomy for hepatocellular carcinoma.Methods The clinical data of 89 patients who received liver resection for hepatocellular carcinoma in our hospital from January 2007 to January 2010 were studied retrospectively.41patients received PVCE (the treatment group) while 48 patients received no PVCE (the control group).Postoperative recurrence and cumulative disease free survivals were compared using the Kaplan-Meier method.Results On follow-up which ranged from 6-42 months,the 1- and 2-year disease free survivals were 76.5％ and 48.0％ in the treatment group,and 53.8％ and 25.8％ respectively in the control group (P＜0.05).The mean disease free survivals were 19.91 (95％ CI,16.09-23.73)and 13.8 months (95 ％ CI,10.95-16.65),respectively.The cumulative disease free survivals in the PVCE group were significantly higher than the control group (P=0.01).Cox multivariate analysis showed that adjuvant PVCE,tumor size,portal vein thrombosis,and postoperative transcatheter arterial chemoembolization (TACE) were independent factors of disease free survival.Conclusion Adjuvant PVCE was effective in preventing postoperative recurrence of hepatocellular carcinoma after partial hepatectomy.