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一种中药复方制剂与小肝癌切除术后介入治疗的比较:22 年随访。

A traditional Chinese herbal medicine compound preparation versus interventional therapy after resection of small hepatocellular carcinoma: 22-year follow-up.

机构信息

Department of Sanitarium Area, Nanjing General Hospital of Nanjing Military Command, PLA, Nanjing 211131, China.

出版信息

J Tradit Chin Med. 2012 Jun;32(2):156-63. doi: 10.1016/s0254-6272(13)60005-9.

Abstract

OBJECTIVE

To compare the long-term effectiveness of compound Ruanjianhugan(RJH)tablets and interventional therapy (IT) in patients after resection of small hepatocellular carcinoma (HCC). in 399 patients after resection of small HCC who were admitted between January 1987 and December 2008 in the Department of Hepatobiliary Surgery and Center of Minimally Invasive Surgery, First Affiliated Hospital of Guangxi Medical University. Four groups were based on different therapy modes: a TCM-only (TCMO) group, a TCM combined with interventional therapy (TCM-IT) group, an interventional therapy-only (ITO) group, and a simple operation (SO) group. Prognostic factors were correlated with overall survival (OS) and OS rates were calculated with the Kaplan-Meier method, and multivariate analyses for factors affecting survival were evaluated by the Cox proportional hazard model.

RESULTS

The median OS was 151.20 months in the TCM-IT group, 43.87 months in the ITO group, and 20.77 months in the SO group. All survival rates of the TCMO group were higher than those of the other three groups (>50%). The 5-, 10-, and 15-year OS in the TCMO and ITO patients were 83.94%, 45.50%, and 71.22% and 33.34%, 55.58%, and 9.26%, respectively (risk ratio, 0.209; 95% confidence interval, 0.126-0.347; P = 0.000). Multivariate analysis revealed that the independent risk factors were therapy mode (P = 0.000), sex (P = 0.005), family history (P = 0.011), TNM classification of malignant tumor staging (P = 0.000), medical care-seeking behavior (P = 0.021), and maximum diameter (P = 0.030).

CONCLUSION

Long-term oral use of compound RJH tablets may improve OS for small HCC after resection compared with IT.

摘要

目的

比较复方软肝煎剂与介入治疗(IT)对小肝癌(HCC)切除术后患者的长期疗效。

方法

在广西医科大学第一附属医院肝胆外科和微创中心,1987 年 1 月至 2008 年 12 月期间收治的 399 例小 HCC 切除术后患者,根据不同的治疗模式分为四组:单纯中药(TCMO)组、中药联合介入治疗(TCM-IT)组、单纯介入治疗(ITO)组和单纯手术(SO)组。采用 Kaplan-Meier 法计算总生存率(OS),并绘制生存曲线,Cox 比例风险模型进行多因素分析。

结果

TCM-IT 组中位 OS 为 151.20 个月,ITO 组为 43.87 个月,SO 组为 20.77 个月。TCMO 组所有生存率均高于其他三组(>50%)。TCMO 和 ITO 患者的 5、10 和 15 年 OS 率分别为 83.94%、45.50%和 71.22%和 33.34%、55.58%和 9.26%(风险比,0.209;95%置信区间,0.126-0.347;P=0.000)。多因素分析显示,独立危险因素为治疗方式(P=0.000)、性别(P=0.005)、家族史(P=0.011)、恶性肿瘤 TNM 分期(P=0.000)、就医行为(P=0.021)和最大直径(P=0.030)。

结论

与 IT 相比,长期口服复方软肝煎剂可能会提高小 HCC 切除术后的 OS。

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