肝切除术或联合化疗栓塞及射频消融可提高肝细胞癌患者的生存率。

Liver resection or combined chemoembolization and radiofrequency ablation improve survival in patients with hepatocellular carcinoma.

作者信息

Helmberger Thomas, Dogan Selin, Straub Gundula, Schrader Angelika, Jüngst Christoph, Reiser Maximilian, Waggershauser Tobias, Jakobs Tobias, Hoffmann Ralf-Thorsten, Löhe Florian, Graeb Christian, Rau Horst-Günter, Schauer Rolf, Jauch Karl-Walter, Caselmann Wolfgang H, Göke Burkhard, Jüngst Dieter

机构信息

Department of Radiology, Klinikum Schleswig-Holstein, University of Lübeck, Lübeck, Germany.

出版信息

Digestion. 2007;75(2-3):104-12. doi: 10.1159/000104730. Epub 2007 Jun 26.

DOI:10.1159/000104730

PMID:17598962

Abstract

BACKGROUND/AIMS: To evaluate the long-term outcome of surgical and non-surgical local treatments of patients with hepatocellular carcinoma (HCC).

METHODS

We stratified a cohort of 278 HCC patients using six independent predictors of survival according to the Vienna survival model for HCC (VISUM-HCC).

RESULTS

Prior to therapy, 224 HCC patients presented with VISUM stage 1 (median survival 18 months) while 29 patients were classified as VISUM stage 2 (median survival 4 months) and 25 patients as VISUM stage 3 (median survival 3 months). A highly significant (p < 0.001) improved survival time was observed in VISUM stage 1 patients treated with liver resection (n = 52; median survival 37 months) or chemoembolization (TACE) and subsequent radiofrequency ablation (RFA) (n = 44; median survival 45 months) as compared to patients receiving chemoembolization alone (n = 107; median survival 13 months) or patients treated by tamoxifen only (n = 21; median survival 6 months). Chemoembolization alone significantly (p < or = 0.004) improved survival time in VISUM stage 1-2 patients but not (p = 0.341) in VISUM stage 3 patients in comparison to those treated by tamoxifen.

CONCLUSION

Both liver resection or combined chemoembolization and RFA improve markedly the survival of patients with HCC.

摘要

背景/目的：评估肝细胞癌（HCC）患者手术及非手术局部治疗的长期疗效。

方法

根据HCC维也纳生存模型（VISUM-HCC），我们使用六个独立的生存预测指标对278例HCC患者进行分层。

结果

治疗前，224例HCC患者为VISUM 1期（中位生存期18个月），29例为VISUM 2期（中位生存期4个月），25例为VISUM 3期（中位生存期3个月）。与单纯接受化疗栓塞（n = 107；中位生存期13个月）或仅接受他莫昔芬治疗（n = 21；中位生存期6个月）的患者相比，接受肝切除（n = 52；中位生存期37个月）或化疗栓塞（TACE）及随后射频消融（RFA）（n = 44；中位生存期45个月）的VISUM 1期患者的生存时间有显著改善（p < 0.001）。与接受他莫昔芬治疗的患者相比，单纯化疗栓塞在VISUM 1-2期患者中显著改善了生存时间（p ≤ 0.004），但在VISUM 3期患者中未显著改善（p = 0.341）。