介入放射学杂志
介入放射學雜誌
개입방사학잡지
JOURNAL OF INTERVENTIONAL RADIOLOGY
2014年
4期
299-302
,共4页
丁以锟%吕维富%周春泽%鲁东%唐文静
丁以錕%呂維富%週春澤%魯東%唐文靜
정이곤%려유부%주춘택%로동%당문정
肝癌术后%生存%预防%肝动脉化疗栓塞%预后
肝癌術後%生存%預防%肝動脈化療栓塞%預後
간암술후%생존%예방%간동맥화료전새%예후
liver cancer after surgery%survival%prophylaxis%transcatheter arterial chemoemho-lization%prognosis
目的：探讨术后行预防性肝动脉化疗栓塞（TACE）对肝细胞癌（HCC）患者生存的影响及预后相关因素分析。方法回顾性分析我院2008年1月-2012年11月确诊肝癌行根治性肝切除且术后行TACE治疗的92例患者的临床和随访资料。将术后2个月内影像学检查未发现病灶行预防性TACE者为预防组；按期随访直至复发再行TACE者为对照组，用Kaplan-Meier法比较两组生存差异，并采用COX回归分析影响肝癌术后患者生存及预后的相关因素。结果92例患者中预防组为38例，对照组54例，两组患者基线资料比较差异无统计学意义。预防组1、2、3年生存率分别为85.1%、56.8%、56.8%，中位生存时间为39个月；对照组分别为65.2%、43.4%、30.4%，中位生存时间为21个月。预防组和对照组累计生存率差异有统计学意义（P=0.021）。在单因素分析中门脉癌栓、肿瘤直径、腹水、凝血酶原时间及是否行预防性TACE是可能影响预后的相关因素。多因素分析中，是否行预防性TACE及肿瘤直径是显著影响预后的独立相关因素。结论肝癌患者术后行预防性TACE可明显提高患者的生存率，另外肿瘤直径也是显著影响预后的独立相关因素。
目的：探討術後行預防性肝動脈化療栓塞（TACE）對肝細胞癌（HCC）患者生存的影響及預後相關因素分析。方法迴顧性分析我院2008年1月-2012年11月確診肝癌行根治性肝切除且術後行TACE治療的92例患者的臨床和隨訪資料。將術後2箇月內影像學檢查未髮現病竈行預防性TACE者為預防組；按期隨訪直至複髮再行TACE者為對照組，用Kaplan-Meier法比較兩組生存差異，併採用COX迴歸分析影響肝癌術後患者生存及預後的相關因素。結果92例患者中預防組為38例，對照組54例，兩組患者基線資料比較差異無統計學意義。預防組1、2、3年生存率分彆為85.1%、56.8%、56.8%，中位生存時間為39箇月；對照組分彆為65.2%、43.4%、30.4%，中位生存時間為21箇月。預防組和對照組纍計生存率差異有統計學意義（P=0.021）。在單因素分析中門脈癌栓、腫瘤直徑、腹水、凝血酶原時間及是否行預防性TACE是可能影響預後的相關因素。多因素分析中，是否行預防性TACE及腫瘤直徑是顯著影響預後的獨立相關因素。結論肝癌患者術後行預防性TACE可明顯提高患者的生存率，另外腫瘤直徑也是顯著影響預後的獨立相關因素。
목적：탐토술후행예방성간동맥화료전새（TACE）대간세포암（HCC）환자생존적영향급예후상관인소분석。방법회고성분석아원2008년1월-2012년11월학진간암행근치성간절제차술후행TACE치료적92례환자적림상화수방자료。장술후2개월내영상학검사미발현병조행예방성TACE자위예방조；안기수방직지복발재행TACE자위대조조，용Kaplan-Meier법비교량조생존차이，병채용COX회귀분석영향간암술후환자생존급예후적상관인소。결과92례환자중예방조위38례，대조조54례，량조환자기선자료비교차이무통계학의의。예방조1、2、3년생존솔분별위85.1%、56.8%、56.8%，중위생존시간위39개월；대조조분별위65.2%、43.4%、30.4%，중위생존시간위21개월。예방조화대조조루계생존솔차이유통계학의의（P=0.021）。재단인소분석중문맥암전、종류직경、복수、응혈매원시간급시부행예방성TACE시가능영향예후적상관인소。다인소분석중，시부행예방성TACE급종류직경시현저영향예후적독립상관인소。결론간암환자술후행예방성TACE가명현제고환자적생존솔，령외종류직경야시현저영향예후적독립상관인소。
Objective To investigate the influence of postoperative transcatheter arterial chemoembo-lization (TACE) on the survival time and prognosis in hepatocellular carcinoma (HCC) patients after liver resection. Methods During the period from January 2008 to November 2012, a total of 92 patients with HCC were admitted to authors’ hospital, and all the patients received TACE after liver resection. The clinical data were retrospectively analyzed. Those patients who showed no lesions on imaging examination within two months after the surgery were classified in prevention group (n=38) and prophylactic TACE was carried out after the surgery. Those patients who did not receive TACE until recurrence was detected on imaging examination were regarded as control group (n = 54). The difference in the survival time between the two groups was analyzed by using Kaplan Meier method, while the related factors influencing postoperative survival time and prognosis were analyzed by using COX regression method. Results No statistically significant difference in the baseline data existed between the two groups. The one-year, 2-year and 3-year survival rates of all the patients were 71%, 48% and 41% respectively, with a median survival time of 24.1 months. For the prevention group, the one-year, 2-year and 3-year survival rates were 85.1%, 56.8% and 56.8% respectively, with a median survival time of 39 months. For the control group, the one-year, 2-year and 3-year survival rates were 65.2%, 43.4% and 30.4% respectively, with a median survival time of 21 months. The difference in the cumulated survival rate between the two groups was statistically significant(P = 0.021). Both the single factor analysis and multifactor analysis showed that, like tumor thrombus in portal vein, tumor diameter, ascites, prothrombin time, etc. the use of postoperative prophylactic TACE was a related factor that could significantly influence the postoperative survival time and prognosis. Conclusion The use of postoperative prophylactic TACE can obviously improve the survival rate of liver cancer patients. The tumor diameter is also an independent factor that can significantly affect the prognosis.(J Intervent Radiol, 2014, 23:299-302).
