摘要
目的观察辅助性肝动脉化疗栓塞（TACE）对肝细胞癌根治术后近期（〈2年）复发的作用。方法回顾性收集自2000年11月至2007年12月问2591例接受根治性手术切除的肝细胞癌患者的资料。根据术后是否行辅助性TACE分为干预组和对照组；再根据肿瘤直径、数目以及有无镜下癌栓将入选病例分为肿瘤直径≤5em的残癌低危、高危组以及肿瘤直径〉5cm的残癌低危、高危组。其中残癌低危定义为肿瘤单个且无镜下癌栓；残癌高危为肿瘤数目2～3个和（或）有镜下癌栓。分析辅助性TACE对近期复发的影响。结果对照组与干预组比较，术后3个月内的复发率在肿瘤直径≤5cm的残癌低危组和高危组分别为1．34％比4．14％（P=0．002）和3．17％比8．15％（P=0．011），肿瘤直径〉5cm的残癌低危组和高危组分别为5．33％比12．88％（P=0．002）和8．43％比14．29％（P=0．045）；6个月内的复发率在肿瘤直径≤5cm的残癌低危组和高危组分别为4．63％比6．71％（P=0．133）和8．73％比13．48％（P=0．070），肿瘤直径〉5em的残癌低危组和高危组分别为11．50％比21．02％（P=0．052）和19．64％比23．94％（P=0．070）。那些6个月内未发生复发的患者，其术后9、12、18、24个月内的复发率在各亚组的对照组与干预组间均无明显差异。结论术后辅助性TACE治疗本身并不能预防近期复发，但其操作过程有助于早期发现术后残癌和复发灶。
Objective To explore the effect of postoperative adjuvant transarterial chemoembolization （TACE） upon early recurrence of hepatocellular carcinoma （HCC） patients after radical resection. Methods Between November 2000 and December 2007, 2591 HCC patients undergoing radical resection were retrospectively recruited. Patients undergoing resection alone were selected as control group while those receiving post-operative adjuvant TACE as intervention group. The patients were further stratified into tumor ≤5 cm with low or high risk factors for residual tumor and tumor 〉 5 cm with low or high risk factors for residual tumor. A low risk factor for residual tumor was defined as single tumor and without microscopic tumor thrombus while a high risk factor for residual tumor was defined as 2 - 3 nodules or with the presence of microscopic tumor thrombus. The effect of adjuvant TACE upon early （ ~〈 2 years ） recurrence was evaluated. Results Recurrent rates of tumor ~〈 5 cm with low or high risk factors for residual tumor and tumor 〉 5 cm with low or high risk factors for residual tumor at Month 3 post-resection were 1.34%, 3.17%, 5.33% and 8.43% in the control group versus 4. 14% （P =0. 002）, 8. 15% （P = 0. 011 ） , 12. 88% （P =0. 002） and 14.29% （P =0. 045） respectively in the intervention group; recurrence rates at Month 6 post-resection were 4.63%, 8.73%, 11.50% and 19.46% in the control group versus 6.71% （P =0. 133）, 13.48% （P =0. 070）, 21.02% （P =0. 052） and 23.94% （P =0. 210） respectively in the intervention group. For patients remaining recurrence free within the first 6 months post-resection, there were no significant differenees in recurrence rates at Months 9, 12, 18 and 24 post-operation between each intervention group and control group. Conclusion Postoperative adjuvant TACE has no preventive effect upon early recurrence, but may be of benefit to detect residual tumor and early recurrence.
出处
《中华医学杂志》
CAS
CSCD
北大核心
2010年第12期826-829,共4页
National Medical Journal of China
关键词
癌
肝细胞
根治术
肝动脉化疗栓塞
Hepatocellular carcinoma
Radical resection
Transarterial chemoembolization
