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肝部分切除术后复发性肝细胞癌:经动脉化疗栓塞治疗的价值

Recurrent hepatocellular carcinoma after partial hepatectomy: value of treatment with transcatheter arterial chemoembolization.

作者信息

Nakoa N, Kamino K, Miura K, Hayashi T, Ohnishi M, Takayasu Y, Miura T, Okamoto E

机构信息

Department of Radiology, Hyogo College of Medicine, Nishinomiya, Japan.

出版信息

AJR Am J Roentgenol. 1991 Jun;156(6):1177-9. doi: 10.2214/ajr.156.6.1851379.

Abstract

The usefulness of transcatheter arterial chemoembolization (TACE) of the hepatic artery was retrospectively evaluated in 66 patients who underwent the procedure for treatment of hepatocellular carcinoma that recurred after partial hepatectomy. The materials infused were Gelfoam sponge or Gelfoam sponge plus Lipiodol and an anticancer agent. A control group of 15 patients with recurrent tumor received oral anticancer agents alone. The cumulative survival rate for the TACE group was 88% for the first year, 57% for 2 years, 42% for 3 years, and 27% for 5 years, whereas that of the control group was 80% for the first year, 27% for 2 years, and 18% for 3 years. Thus, the prognosis of the TACE group was significantly better (p less than or equal to .01, log-rank test) than that of the control group. The survival rate was inversely correlated with the ratio of the volume of the recurrent tumor to the volume of the whole residual liver. These results suggest that TACE is more effective than oral chemotherapy for treatment of hepatocellular carcinoma that recurs after partial hepatectomy.

摘要

对66例接受经导管肝动脉化疗栓塞术(TACE)治疗的患者进行回顾性评估,这些患者均为接受肝部分切除术后复发的肝细胞癌患者。注入的材料为明胶海绵或明胶海绵加碘油及抗癌药。15例复发肿瘤患者组成的对照组仅接受口服抗癌药治疗。TACE组1年累计生存率为88%,2年为57%,3年为42%,5年为27%;而对照组1年为80%,2年为27%,3年为18%。因此,TACE组的预后明显优于对照组(p≤0.01,对数秩检验)。生存率与复发肿瘤体积与整个残余肝体积之比呈负相关。这些结果表明,对于肝部分切除术后复发的肝细胞癌,TACE比口服化疗更有效。

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