Paul Shashi B, Chalamalasetty Sreenivasa Baba, Vishnubhatla Sreenivas, Madan Kaushal, Gamanagatti Shivanand R, Batra Yogesh, Gupta Siddhartha D, Panda Subrat K, Acharya Subrat K
Department of Gastroenterology, All India Institute of Medical Sciences, New Delhi, India.
Oncology. 2009;77(3-4):162-71. doi: 10.1159/000231886. Epub 2009 Jul 28.
To study the profile and outcome of therapy for hepatocellular carcinoma (HCC) in India.
Data analysis of HCC patients enrolled in liver clinic between 1990 and 2005.
We registered 324 HCC patients [males 284 (88%), mean age 52.4 +/- 13.1 years]. The etiology of HCC was: hepatitis B virus 165 (51%), hepatitis C virus 38 (12%), alcohol 20 (6%), combined 31 (10%) and unknown 70 (21%). Serum alpha-fetoprotein was >400 ng in 36%, portal vein invasion was seen in 40% and distant metastases in 13%. Therapy was offered to 141 (43.5%) patients, but survival data was available in only 130 (93%) of them. Treatment given and median survival time was as follows: surgical resection, 19 months (n = 14); transarterial chemoembolization, 11 months (n = 23); transarterial rhenium therapy, 26 months (n = 7); radiofrequency ablation, 24 months (n = 4); acetic acid ablation, 13 months (n = 17); oral chemotherapy, 26 months (n = 33), and combination therapy, 26 months (n = 32). Vascular invasion, Okuda staging and therapy were independent factors associated with survival. Treated patients had longer median survival compared to untreated ones (16 months vs. 7 months, p < 0.05).
Hepatitis B infection is the predominant cause of HCC in India. Serum alpha-fetoprotein was diagnostic in only one third of our patients. Most patients present late, when curative therapies are not possible. Treated patients had better survival than untreated ones.
研究印度肝细胞癌（HCC）的治疗情况及预后。
对1990年至2005年期间肝病门诊登记的HCC患者进行数据分析。
我们登记了324例HCC患者[男性284例（88%），平均年龄52.4±13.1岁]。HCC的病因如下：乙型肝炎病毒165例（51%），丙型肝炎病毒38例（12%），酒精性20例（6%），混合型31例（10%），病因不明70例（21%）。36%的患者血清甲胎蛋白>400 ng，40%可见门静脉侵犯，13%有远处转移。1四十二例（43.5%）患者接受了治疗，但其中仅有130例（93%）有生存数据。所给予的治疗及中位生存时间如下：手术切除，19个月（n = 14）；经动脉化疗栓塞，11个月（n = 23）；经动脉铼治疗，26个月（n = 7）；射频消融，24个月（n = 4）；醋酸消融，13个月（n = 17）；口服化疗，26个月（n = 33），联合治疗，26个月（n = 32）。血管侵犯、奥田分期和治疗是与生存相关的独立因素。与未治疗的患者相比，接受治疗的患者中位生存时间更长（16个月对7个月，p < 0.05）。
在印度，乙型肝炎感染是HCC的主要病因。血清甲胎蛋白仅在三分之一的患者中具有诊断价值。大多数患者就诊时已属晚期，无法进行根治性治疗。接受治疗的患者比未接受治疗的患者生存情况更好。
