Department of Hepatobiliary and Pancreatic Surgery, Sun Yat-sen University Cancer Center, Guangzhou, P. R. China.
State Key Laboratory of Southern China, Guangzhou, P. R. China.
Cancer Med. 2019 Sep;8(11):5097-5107. doi: 10.1002/cam4.2380. Epub 2019 Jul 17.
Transarterial chemoembolization (TACE) is recommended to treat intermediate/advanced stage of hepatocellular carcinoma (HCC). However, the overall survival among initially TACE-treated patients varies significantly. The clinical characterization of long-term survival following TACE remains uncertain. We sought to identify clinical parameters and treatment requirements for long-term survival among patients with hepatitis B-related HCC who were initially treated with TACE.
The included patients with HCC were admitted to our cancer center between December 2009 and May 2015. Patients who survived for >3 years were compared with those who died within 3 years. The clinical and laboratory findings that were associated with the survival were also analyzed.
One in six (17.9%) patients with HCC in this cohort survived for > 3 years after TACE. Body mass index (BMI) ≥ 23kg/m , aspartate aminotransferase levels ≤ 40 U/L, an activated partial thromboplastin time ≤ 34 seconds, α-fetoprotein (AFP) levels ≤ 25 ng/mL, antiviral therapy, tumor size ≤ 8 cm, solitary nodule, and the absence of vascular invasion were independently favorably associated with a 3-year survival. An absence of vascular invasion was the only independent factor associated with 3-year survival in patients who received resection and/or ablation after TACE.
In this cohort, a 3-year survival was associated with BMI, antivirus treatment, tumor status, hepatic function, and AFP level. Distant metastasis did not negatively impact the long-term survival among patients with hepatitis B-related HCC initially treated with TACE. Vascular invasion was the single impediment to long-term survival in patients who received add-on resection and/or ablation after TACE.
经动脉化疗栓塞（TACE）被推荐用于治疗中晚期肝细胞癌（HCC）。然而，初始接受 TACE 治疗的患者的总体生存率差异很大。TACE 治疗后长期生存的临床特征尚不确定。我们试图确定初始接受 TACE 治疗的乙型肝炎相关 HCC 患者的长期生存的临床参数和治疗需求。
本研究纳入了 2009 年 12 月至 2015 年 5 月期间在我院癌症中心就诊的 HCC 患者。将生存时间>3 年的患者与生存时间<3 年的患者进行比较。分析与生存相关的临床和实验室检查结果。
该队列中，1/6（17.9%）的 HCC 患者在 TACE 后生存时间>3 年。体重指数（BMI）≥23kg/m 2 、天门冬氨酸转氨酶（AST）水平≤40U/L、活化部分凝血活酶时间（APTT）≤34 秒、甲胎蛋白（AFP）水平≤25ng/ml、抗病毒治疗、肿瘤直径≤8cm、单结节、无血管侵犯与 3 年生存独立相关。在 TACE 后接受切除术和/或消融治疗的患者中，无血管侵犯是唯一与 3 年生存相关的独立因素。
在本队列中，BMI、抗病毒治疗、肿瘤状态、肝功能和 AFP 水平与 3 年生存率相关。远处转移并不影响初始接受 TACE 治疗的乙型肝炎相关 HCC 患者的长期生存。血管侵犯是 TACE 后接受附加切除术和/或消融治疗的患者长期生存的唯一障碍。
