Zhang Dong-Zhi, Zhang Ke, Wang Xiao-Peng, Cai Hui
Emergency Department, Gansu Provincial Hospital, Lanzhou, China E-mail :
Asian Pac J Cancer Prev. 2015;16(1):315-9. doi: 10.7314/apjcp.2015.16.1.315.
Surgical resection of spontaneously ruptured hepatocellular carcinoma (HCC) after successful transarterial embolization (TAE) remains controversial. The aim of this study was to investigate its efficacy in a series of cases.
We retrospectively examined ruptured HCC cases from Jan 2000 to Dec 2008; all of these 126 cases received TAE as the initial therapy. Subsequently, 74 cases received staged surgical resection, and the remaining 52 cases underwent repeated TACE. The baseline demographic data, tumor characteristics, and long term survival were recorded and compared.
The demographic and baseline characteristics were comparable between the hepatic resection and TACE groups; furthermore, no significant difference in the tumor characteristics was detected between the two groups. The differences in in-hospital, 30- day and 90-day mortality between the two groups were not significant (P>0.05). However, the 1-, 3-, and 5-year overall survival rates were 85.1%, 63.5%, and 37.8%, respectively, in the hepatic resection group, which were significantly higher than those in the TACE group (69.2%, 46.2%, and 17.3%, respectively, P=0.004). Univariate and multivariate analyses indicated that these patients benefitted from hepatic resection compared with TACE with respect to long-term outcomes.
Staged hepatic resection after TAE is an effective treatment that results in superior long-term survival to repeated TACE.
经动脉栓塞术（TAE）成功后，对自发性破裂肝细胞癌（HCC）进行手术切除仍存在争议。本研究旨在探讨其在一系列病例中的疗效。
我们回顾性研究了2000年1月至2008年12月期间破裂性HCC病例；这126例患者均接受TAE作为初始治疗。随后，74例患者接受分期手术切除，其余52例患者接受重复经动脉化疗栓塞术（TACE）。记录并比较了两组患者的基线人口统计学数据、肿瘤特征和长期生存率。
肝切除组和TACE组的人口统计学和基线特征具有可比性；此外，两组之间的肿瘤特征无显著差异。两组患者的住院死亡率、30天和90天死亡率差异均无统计学意义（P>0.05）。然而，肝切除组的1年、3年和5年总生存率分别为85.1%、63.5%和37.8%，显著高于TACE组（分别为69.2%、46.2%和17.3%，P=0.004）。单因素和多因素分析表明，与TACE相比，这些患者从肝切除术中获得了更好的长期预后。
TAE术后分期肝切除是一种有效的治疗方法，与重复TACE相比，其长期生存率更高。
