术前经动脉化疗栓塞对可切除肝细胞癌长期预后的负面影响：一项倾向评分匹配分析
The Negative Effect of Preoperative Transcatheter Arterial Chemoembolization on Long-Term Outcomes for Resectable Hepatocellular Carcinoma: A Propensity Score Matching Analysis.
作者信息
Amisaki Masataka, Honjo Soichiro, Morimoto Masaki, Hanaki Takehiko, Arai Yosuke, Tokuyasu Naruo, Sakamoto Teruhisa, Ohuchi Yasufumi, Saito Hiroaki
机构信息
Division of Surgical Oncology, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, Yonago 683-8504, Japan.
†Division of Radiology, Department of Pathophysiological and Therapeutic Science, School of Medicine, Tottori University Faculty of Medicine, Yonago 683-8503, Japan.
出版信息
Yonago Acta Med. 2016 Dec 26;59(4):270-278. eCollection 2016 Dec.
BACKGROUND
Preoperative transcatheter arterial chemoembolization (TACE) is administered to improve long-term outcome after surgical resection of hepatocellular carcinoma (HCC). However, the survival benefit of preoperative TACE is controversial. We conducted a retrospective case-control study to evaluate the effect of preoperative TACE on prognosis.
METHODS
A total of 121 patients who underwent curative resection of HCC were divided into two groups according to whether they received preoperative TACE. We determined the control group ( = 34) and TACE group ( = 34) through propensity score matching. The primary endpoint of this study was overall survival, and the secondary endpoints were recurrence-free survival.
RESULTS
The overall survival rate and the recurrence free survival rate were significantly lower in the TACE group than in the control group ( = 0.014 and = 0.043, respectively). Furthermore, recurrence free survival within less than 2 years after resection was significantly worse in the TACE group than in the control group ( = 0.035).
CONCLUSION
Preoperative TACE seemed to worsen the long-term outcomes of the patients who underwent surgical resection for the treatment of resectable HCC. Therefore, preoperative TACE should not be considered as a standard therapy in patients with resectable HCC.
背景
术前经动脉化疗栓塞术（TACE）用于改善肝细胞癌（HCC）手术切除后的长期预后。然而，术前TACE的生存获益存在争议。我们进行了一项回顾性病例对照研究，以评估术前TACE对预后的影响。
方法
总共121例行HCC根治性切除术的患者根据是否接受术前TACE分为两组。我们通过倾向评分匹配确定了对照组（n = 34）和TACE组（n = 34）。本研究的主要终点是总生存期，次要终点是无复发生存期。
结果
TACE组的总生存率和无复发生存率显著低于对照组（分别为P = 0.014和P = 0.043）。此外，TACE组切除后2年内的无复发生存情况明显比对照组差（P = 0.035）。
结论
术前TACE似乎会使接受手术切除治疗可切除HCC患者的长期预后恶化。因此，术前TACE不应被视为可切除HCC患者的标准治疗方法。
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