Department of Gastroenterological Surgery, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama 236-0004, Japan.
Anticancer Res. 2013 Dec;33(12):5585-90.
Advanced hepatocellular carcinoma (HCC) with portal vein invasion or intrahepatic metastases has an unfavorable prognosis, even after curative hepatic resection. The aim of the present study was to evaluate the efficacy of adjuvant hepatic arterial infusion chemotherapy with 5-fluorouracil (5-FU) and systemic interferon (IFN).
Patients who were diagnosed as having HCC with portal vein invasion or intrahepatic metastases were included in the study (n=33). Out of these patients, 16 were treated with adjuvant therapy consisting of continuous arterial infusion of 5-FU and subcutaneous injection of IFN-α. Another 17 patients who underwent hepatic resection without adjuvant chemotherapy served as controls.
The five-year cumulative survival rate was significantly higher in the adjuvant treatment group (71.1%) than in the control group (44.0%; p=0.023). The rate of patients with multiple (≥4) recurrent intrahepatic nodules was significantly lower in the adjuvant group (44.4%) than in the control group (100%; p=0.040). The development of intrahepatic recurrence within 12 months was significantly lower in the adjuvant group (33.3%) than in the control group (80.0%; p=0.040).
Our data suggest that this adjuvant chemotherapy can improve postoperative prognosis by reducing intrahepatic recurrence.
即使在根治性肝切除术后，伴有门静脉侵犯或肝内转移的进展期肝细胞癌（HCC）预后仍较差。本研究旨在评估氟尿嘧啶（5-FU）持续动脉输注联合全身干扰素（IFN）辅助肝动脉灌注化疗的疗效。
本研究纳入了诊断为伴有门静脉侵犯或肝内转移的 HCC 患者（n=33）。其中 16 例患者接受辅助治疗，包括 5-FU 持续动脉输注和 IFN-α 皮下注射。另外 17 例患者在未接受辅助化疗的情况下接受了肝切除术作为对照。
辅助治疗组的五年累积生存率明显高于对照组（71.1% vs. 44.0%；p=0.023）。辅助治疗组多发（≥4 个）肝内复发病灶的患者比例明显低于对照组（44.4% vs. 100%；p=0.040）。辅助治疗组肝内复发发生在 12 个月内的患者比例明显低于对照组（33.3% vs. 80.0%；p=0.040）。
我们的数据表明，这种辅助化疗可以通过减少肝内复发来改善术后预后。
