Ke-Wei Li, Tian-Fu Wen, Xi Li, Lü-Nan Yan, Bo Li, Yong Zeng, Wu-Sheng Lu, Wen-Tao Wang, Ming-Qing Xu, Jia-Yin Yang, Yu-Kui Ma, Zhe-Yu Chen
Division of Liver Transplantation, West China Hospital of Sichuan University, Sichuan Province, China.
Hepatogastroenterology. 2012 Sep;59(118):1944-6. doi: 10.5754/hge11845.
BACKGROUND/AIMS: The aim of this study was to evaluate the clinical efficacy of postoperative adjuvant transcatheter arterial chemoembolization (TACE) on hepatocellular carcinoma (HCC) with microscopic venous invasion.
Data from 76 patients with HCC who underwent hepatectomy with or without postoperative adjuvant TACE between July 2005 and August 2010 were retrospectively reviewed. Kaplan-Meier method was used to compare survival between the groups and prognostic factors were evaluated by Cox proportional hazard model.
The 1-, 3- and 5-year disease- free survival rates were 76.3%, 44.5% and 31.8%, respectively, for the adjuvant TACE group (35 patients) and 60.1%, 39.3% and 21.5%, respectively, for the control group (41 patients). The 1-, 3- and 5-year overall survival rates were 88.6%, 67.2% and 42.3%, respectively, for the TACE group and 77.5%, 58.0% and 40.5%, respectively, for the control group. Although improving trends of both disease-free survival and overall survival were observed in adjuvant TACE group, there was no significant difference between the two groups (p>0.05). Cox regression analysis revealed that tumor size and differentiation were significant independent prognostic factors.
Postoperative adjuvant TACE may improve 1, 3 and 5 year disease-free and overall survival rates of HCC patients with microscopic venous invasion but no statistical significance was found. It can be used as a preventative treatment but not a routine procedure for such patients.
背景/目的：本研究旨在评估术后辅助性经动脉化疗栓塞术（TACE）对伴有微小静脉侵犯的肝细胞癌（HCC）的临床疗效。
回顾性分析2005年7月至2010年8月间76例行肝切除术的HCC患者的数据，这些患者接受或未接受术后辅助性TACE。采用Kaplan-Meier法比较两组患者的生存率，并通过Cox比例风险模型评估预后因素。
辅助性TACE组（35例患者）的1年、3年和5年无病生存率分别为76.3%、44.5%和31.8%，对照组（41例患者）分别为60.1%、39.3%和21.5%。TACE组的1年、3年和5年总生存率分别为88.6%、67.2%和42.3%，对照组分别为77.5%、58.0%和40.5%。虽然辅助性TACE组的无病生存率和总生存率均有改善趋势，但两组之间无显著差异（p>0.05）。Cox回归分析显示肿瘤大小和分化程度是显著的独立预后因素。
术后辅助性TACE可能提高伴有微小静脉侵犯的HCC患者的1年、3年和5年无病生存率及总生存率，但未发现统计学意义。它可作为一种预防性治疗方法，但不作为此类患者的常规治疗手段。
