Park Seung Hyun, Cho Yun Ku, Ahn Yong-Sik, Park Yoon-Ok, Kim Jae Kyun, Chung Jin Wook
Department of Radiology, Seoul Veterans Hospital, Gangdong-Gu, Seoul, Korea.
Korean J Radiol. 2007 Mar-Apr;8(2):111-9. doi: 10.3348/kjr.2007.8.2.111.
To determine the prognostic factors for local recurrence of nodular hepatocellular carcinoma after segmental transarterial chemoembolization.
Seventy-four nodular hepatocellular carcinoma tumors < or = 5 cm were retrospectively analyzed for local recurrence after segmental transarterial chemoembolization using follow-up CT images (median follow-up of 17 months, 4-77 months in range). The tumors were divided into four groups (IA, IB, IIA, and IIB) according to whether the one-month follow-up CT imaging, after segmental transarterial chemoembolization, showed homogeneous (Group I) or inhomogeneous (Group II) iodized oil accumulation, or whether the tumors were located within the liver segment (Group A) or in a segmental border zone (Group B). Comparison of tumor characteristics between Group IA and the other three groups was performed using the chi-square test. Local recurrence rates were compared among the groups using the Kaplan-Meier estimation and log rank test.
Local tumor recurrence occurred in 19 hepatocellular carcinoma tumors (25.7%). There were: 28, 18, 17, and 11 tumors in Group IA, IB, IIA, and IIB, respectively. One of 28 (3.6%) tumors in Group IA, and 18 of 46 (39.1%) tumors in the other three groups showed local recurrence. Comparisons between Group IA and the other three groups showed that the tumor characteristics were similar. One-, two-, and three-year estimated local recurrence rates in Group IA were 0%, 11.1%, and 11.1%, respectively. The difference between Group IA and the other three groups was statistically significant (p = 0.000).
An acceptably low rate of local recurrence was observed for small or intermediate nodular tumors located within the liver segment with homogeneous iodized oil accumulation.
确定节段性经动脉化疗栓塞术后结节性肝细胞癌局部复发的预后因素。
回顾性分析74例最大直径≤5 cm的结节性肝细胞癌患者，在节段性经动脉化疗栓塞术后利用CT随访影像（中位随访时间17个月，范围4 - 77个月）评估局部复发情况。根据节段性经动脉化疗栓塞术后1个月的CT影像显示碘油沉积均匀（I组）或不均匀（II组），以及肿瘤位于肝段内（A组）或段间交界区（B组），将肿瘤分为四组（IA、IB、IIA和IIB）。采用卡方检验比较IA组与其他三组之间的肿瘤特征。使用Kaplan-Meier估计法和对数秩检验比较各组的局部复发率。
19例肝细胞癌肿瘤（25.7%）出现局部复发。IA、IB、IIA和IIB组分别有28、18、17和11例肿瘤。IA组28例肿瘤中有1例（3.6%）出现局部复发，其他三组46例肿瘤中有18例（39.1%）出现局部复发。IA组与其他三组的比较显示肿瘤特征相似。IA组1年、2年和3年的估计局部复发率分别为0%、11.1%和11.1%。IA组与其他三组之间的差异具有统计学意义（p = 0.000）。
对于位于肝段内且碘油沉积均匀的小或中等大小结节性肿瘤，观察到局部复发率较低。
