Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 388-1 Poongnap-2dong, Songpa-gu, Seoul 138-736, Republic of Korea.
J Vasc Interv Radiol. 2011 Jul;22(7):917-23. doi: 10.1016/j.jvir.2011.03.005. Epub 2011 May 14.
To evaluate the factors associated with tumor response and survival after chemoembolization in 362 patients with hepatocellular carcinoma (HCC).
Between January 2006 and August 2006, 362 patients who underwent chemoembolization for unresectable HCC were evaluated. The endpoints were tumor response and patient survival. Factors associated with tumor response were evaluated using multivariate logistic regression analysis. Factors associated with patient survival were evaluated using multivariate Cox regression analysis.
After chemoembolization, 69% of the study patients showed a tumor response. On multivariate analysis, tumor size (centimeter) (odds ratio [OR] 2.85, P = .002), tumor number (OR 4.58, P < .001), tumor vascularity (OR 11.97, P < .001), and portal vein invasion (OR 4.24, P < .001) were significant factors for tumor response. The median survival was 23 months. On multivariate analysis, Child-Pugh class (hazard ratio [HR] 2.43, P < .001), maximal tumor size (HR 1.66, P = .002), tumor vascularity (HR 2.13, P = .001), portal vein invasion (HR 2.39, P < .001), tumor number (HR, 1.92, P < .001), and alpha fetoprotein (AFP) value (HR 1.54, P = .003) were significant factors associated with patient survival after chemoembolization.
Tumor size, tumor vascularity, tumor number, and portal vein invasion are significant independent predictors of tumor response after chemoembolization in patients with unresectable HCC. Child-Pugh class B or C, large tumor size (≥ 4 cm), multiple tumors (five or more), portal vein invasion, and a high AFP value (> 83 ng/mL) indicated poor prognosis for overall patient survival after chemoembolization.
评估 362 例不可切除肝细胞癌（HCC）患者经化疗栓塞治疗后肿瘤反应和生存的相关因素。
2006 年 1 月至 2006 年 8 月，对 362 例接受不可切除 HCC 化疗栓塞治疗的患者进行了评估。终点是肿瘤反应和患者生存。采用多变量逻辑回归分析评估与肿瘤反应相关的因素。采用多变量 Cox 回归分析评估与患者生存相关的因素。
化疗栓塞后，69%的研究患者肿瘤反应。多变量分析显示，肿瘤大小（厘米）（优势比[OR]2.85，P=0.002）、肿瘤数量（OR4.58，P<0.001）、肿瘤血管生成（OR11.97，P<0.001）和门静脉侵犯（OR4.24，P<0.001）是肿瘤反应的显著因素。中位生存时间为 23 个月。多变量分析显示，Child-Pugh 分级（风险比[HR]2.43，P<0.001）、最大肿瘤大小（HR1.66，P=0.002）、肿瘤血管生成（HR2.13，P=0.001）、门静脉侵犯（HR2.39，P<0.001）、肿瘤数量（HR1.92，P<0.001）和甲胎蛋白（AFP）值（HR1.54，P=0.003）是化疗栓塞后患者生存的显著相关因素。
肿瘤大小、肿瘤血管生成、肿瘤数量和门静脉侵犯是不可切除 HCC 患者化疗栓塞后肿瘤反应的显著独立预测因素。Child-Pugh 分级 B 或 C、肿瘤较大（≥4cm）、多个肿瘤（≥5 个）、门静脉侵犯和 AFP 值较高（>83ng/ml）预示着化疗栓塞后患者总体生存预后不良。
