经动脉化疗栓塞术对转移性肝细胞癌患者的生存获益：单中心经验
Survival benefit of transarterial chemoembolization in patients with metastatic hepatocellular carcinoma: a single center experience.
作者信息
Bettinger Dominik, Spode Renan, Glaser Nicolas, Buettner Nico, Boettler Tobias, Neumann-Haefelin Christoph, Brunner Thomas Baptist, Gkika Eleni, Maruschke Lars, Thimme Robert, Schultheiss Michael
机构信息
Department of Medicine II, Medical Center University of Freiburg, Faculty of Medicine, University of Freiburg, Hugstetter Str. 55, D-79106, Freiburg, Germany.
Berta-Ottenstein-Programme, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
出版信息
BMC Gastroenterol. 2017 Aug 10;17(1):98. doi: 10.1186/s12876-017-0656-z.
BACKGROUND
As prognosis of patients with metastatic hepatocellular carcinoma (HCC) is mainly determined by intrahepatic HCC progression, local treatment with TACE may result in improved OS, although it is not recommended. The purpose of this study was to analyze retrospectively the efficacy of TACE and its impact on OS in patients with metastatic hepatocellular carcinoma (HCC).
METHODS
Two hundred and fifteen patients with metastatic HCC who were treated at our Liver Center between 2003 and 2014 were included in this retrospective analysis. Medical records, laboratory parameters and imaging studies were analyzed. Treatment of metastatic HCC and OS were assessed RESULTS: One hundred and two patients (47.4%) did not receive any HCC specific treatment while 48 patients (22.3%) were treated with sorafenib, 42 patients (19.5%) with TACE and 23 patients (10.7%) received treatment with TACE and sorafenib in combination. Survival analyses and Cox regression models revealed that TACE and a combination therapy of TACE and sorafenib were significant prognostic factors in metastatic HCC. However, further analyses revealed that there was no additional prognostic effect of adding sorafenib to TACE treatment in this patient cohort.
CONCLUSIONS
In metastatic HCC, treatment of intrahepatic tumor by TACE may be associated with improved survival. These results support the prognostic importance of treating intrahepatic HCC even in patients with metastatic disease. Therefore, we suggest evaluating the technical feasibility of TACE in all metastatic patients.
背景
由于转移性肝细胞癌（HCC）患者的预后主要取决于肝内HCC的进展，经动脉化疗栓塞术（TACE）局部治疗可能会改善总生存期（OS），尽管不推荐使用。本研究的目的是回顾性分析TACE对转移性肝细胞癌（HCC）患者的疗效及其对总生存期的影响。
方法
本回顾性分析纳入了2003年至2014年在我们肝脏中心接受治疗的215例转移性HCC患者。分析病历、实验室参数和影像学研究。评估转移性HCC的治疗和总生存期。
结果
102例患者（47.4%）未接受任何HCC特异性治疗，48例患者（22.3%）接受索拉非尼治疗，42例患者（19.5%）接受TACE治疗，23例患者（10.7%）接受TACE与索拉非尼联合治疗。生存分析和Cox回归模型显示，TACE以及TACE与索拉非尼联合治疗是转移性HCC的重要预后因素。然而，进一步分析显示，在该患者队列中，TACE治疗联合索拉非尼并无额外的预后效果。
结论
在转移性HCC中，TACE治疗肝内肿瘤可能与生存期改善相关。这些结果支持了即使在转移性疾病患者中治疗肝内HCC的预后重要性。因此，我们建议评估所有转移性患者中TACE的技术可行性。
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