CAJ | 학술논문

目的探讨术前行经肝动脉化疗栓塞(transcatheter arterial chemoembolization,TACE)对肝癌切除术中及术后的影响.方法回顾分析原发性肝癌行肝癌切除(A组)和行一次TACE再行肝癌切除(B组)的患者资料.结果 B组患者TACE后肿瘤体积较术前缩小,差异有统计学意义(t=3.31,P=0.021),肿瘤周围可见假包膜形成,肿瘤周围卫星灶显示清晰.A组患者肿瘤无包膜,边界难定.2组患者术中出血量比较差异无统计学意义(t=1.21,P=0.067),B组手术时间较A组长,差异有统计学意义(t =2.71,P=0.046).B组胸腔积液发生率高于A组,差异有统计学意义(x2 =3.51,P=0.039).2组患者并发症总体发生率比较差异无统计学意义(x2=2.016,P=0.183).A组切缘复发率高于B组,差异有统计学意义(x2=3.85,P=0.031),肝内远处复发率高于B组,差异有统计学意义(x2=2.76,P=0.046).从第2年起B组的总生存率高于A组,差异有统计学意义(x2=3.37,P=0.043),2组患者的1、2、3年无瘤生存率比较差异无统计学意义(x2=0.06,P=0.965).结论术前TACE能使肿瘤缩小,减少切缘复发及肝内远处转移,提高生存率.
목적 탐토술전행경간동맥화료전새(transcatheter arterial chemoembolization,TACE)대간암절제술중급술후적영향.방법 회고분석원발성간암행간암절제(A조)화행일차TACE재행간암절제(B조)적환자자료.결과 B조환자TACE후종류체적교술전축소,차이유통계학의의(t=3.31,P=0.021),종류주위가견가포막형성,종류주위위성조현시청석.A조환자종류무포막,변계난정.2조환자술중출혈량비교차이무통계학의의(t=1.21,P=0.067),B조수술시간교A조장,차이유통계학의의(t =2.71,P=0.046).B조흉강적액발생솔고우A조,차이유통계학의의(x2 =3.51,P=0.039).2조환자병발증총체발생솔비교차이무통계학의의(x2=2.016,P=0.183).A조절연복발솔고우B조,차이유통계학의의(x2=3.85,P=0.031),간내원처복발솔고우B조,차이유통계학의의(x2=2.76,P=0.046).종제2년기B조적총생존솔고우A조,차이유통계학의의(x2=3.37,P=0.043),2조환자적1、2、3년무류생존솔비교차이무통계학의의(x2=0.06,P=0.965).결론 술전TACE능사종류축소,감소절연복발급간내원처전이,제고생존솔.
Objective To evaluate the effect of preoperative transarterial chemoembolization (TACE) for resectable hepatocellular carcinoma (HCC).Methods HCC patients undergoing up-front hepatectomy (group A) were compared with those receiving TACE before hepatectomy (group B).Results Tumor size decreased significantly after TACE (t =3.3 1,P =0.021).The rates of tumor encapsulation and liver adhesions were significantly more often seen in group B.There were fewer tumor-residual and more frequent necrosis in group B.Operative time in group B was longer (t =2.71 ,P =0.046).The average blood loss and complication rate were of no difference between the two groups.The occurrence of pleural effusion and intrahepatic recurrence rate in group A was higher than group B (x2 =3.85 ,P =0.031) (x2 =2.76,P =0.046).The overall survival rate from the second year postoperative in group B was higher than group A (x2 =3.37, P =0.043).Conclusions TACE could diminish tumor, advance encapsulation and reduce tumor-residual.Preoperative TACE does not improve 1-, 2-, and 3-year tumor-free survival rates but improve 1-, 2-, and 3-year overall survival rates.