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术后辅助动脉化疗栓塞术可提高乙型肝炎病毒相关肝细胞癌患者的生存率:一项回顾性对照研究。

Postoperative adjuvant arterial chemoembolization improves the survival of hepatitis B virus-related hepatocellular carcinoma: a retrospective control study.

作者信息

Li F, Guo Z, Zhang Y, Wang H, Zhang X, Si T, Yu H, Qi L

机构信息

Department of Interventional Treatment, Tianjin Medical University Cancer Hospital and Institution, Tianjin Key Laboratory of Cancer Prevention and Therapy, Huanhuxi Road, Hexi District, Tianjin, 300060, China.

Department of Lymphoma and Myeloma, The University of Texas M.D. Anderson Cancer Center, Houston, TX, USA.

出版信息

Ir J Med Sci. 2015 Dec;184(4):753-9. doi: 10.1007/s11845-014-1164-6. Epub 2014 Jun 28.

Abstract

BACKGROUND

The survival benefit of postoperative adjuvant transcatheter arterial chemoembolization (TACE) remains controversial.

AIMS

We aim to investigate the survival effect of postoperative adjuvant TACE on the prognosis of hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC) patients (stage B, the Barcelona Clinic Liver Cancer staging).

METHODS

Sixty consecutive HBV-related HCC patients (stage B) from February 2006 to May 2009 undergoing surgical resection were included in this study. Of these 60 patients, 34 patients underwent surgery only (Group A) and 26 patients underwent surgery plus TACE (Group B). We followed-up until May 2013. Overall survival rates as well as prognostic factors were analyzed by the Kaplan-Meier method, the log-rank test or Cox's proportional hazard model. All patients' data were collected from the hospital medical records, which were described precisely after accurate clinical samples detection.

RESULTS

The 1-, 2-, and 3-year overall survival rates in surgery-only group were 58.8, 32.4 and 12.6%, and the rates in surgery plus TACE group were 73.1, 61.5, and 48.9%, respectively (P = 0.033). The median survival time of the two groups after surgery and surgery plus TACE was 15.0 months [95% confidence interval (CI) 10.714-19.286] and 35.0 months (95% CI 20.974-49.026). In multivariate analysis, hemoglobin, HBeAg, peripheral blood regulatory T cells and tumor size were independent prognostic elements for HBV-related HCC patients (stage B).

CONCLUSIONS

Postoperative adjuvant TACE improves the survival of patients with HBV-related HCC (stage B) after curative resection compared to surgery only.

摘要

背景

术后辅助经动脉化疗栓塞术(TACE)的生存获益仍存在争议。

目的

我们旨在研究术后辅助TACE对乙型肝炎病毒(HBV)相关肝细胞癌(HCC)患者(巴塞罗那临床肝癌分期B期)预后的生存影响。

方法

本研究纳入了2006年2月至2009年5月连续60例接受手术切除的HBV相关HCC患者(B期)。这60例患者中,34例仅接受手术(A组),26例接受手术加TACE(B组)。我们随访至2013年5月。采用Kaplan-Meier法、对数秩检验或Cox比例风险模型分析总生存率及预后因素。所有患者的数据均从医院病历中收集,在准确的临床样本检测后进行精确描述。

结果

单纯手术组的1年、2年和3年总生存率分别为58.8%、32.4%和12.6%,手术加TACE组的生存率分别为73.1%、61.5%和48.9%(P = 0.033)。手术组和手术加TACE组术后的中位生存时间分别为15.0个月[95%置信区间(CI)10.714 - 19.286]和35.0个月(95% CI 20.974 - 49.026)。多因素分析中,血红蛋白、HBeAg、外周血调节性T细胞和肿瘤大小是HBV相关HCC患者(B期)的独立预后因素。

结论

与单纯手术相比,术后辅助TACE可提高HBV相关HCC(B期)患者根治性切除后的生存率。

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