肝癌患者术后门静脉浸润行辅助动脉内灌注化疗可提高生存率获益。

Increased Survival Benefit of Adjuvant Intra-arterial Infusion Chemotherapy in HCC Patients with Portal Vein Infiltration after Hepatectomy.

机构信息

Division of Hepato-Biliary-Pancreas Surgery, Department of Surgery, Faculty of Medicine, University of Miyazaki, Kihara 5200, Kiyotake, 889-1692, Miyazaki, Japan.

Department of Surgery, Faculty of Medicine, Tano-Branch Hospital of University of Miyazaki, Miyazaki, Japan.

出版信息

World J Surg. 2020 Aug;44(8):2770-2776. doi: 10.1007/s00268-020-05527-w.

DOI:10.1007/s00268-020-05527-w

PMID:32318792

Abstract

BACKGROUND

The role of adjuvant hepatic intra-arterial infusion chemotherapy (HAI) is considered to be a promising option.

METHODS

We examined treatment effects of adjuvant HAI using cisplatin in 37 hepatocellular carcinoma (HCC) patients with portal vein infiltration (PVI) who underwent hepatectomy in comparison with those in 85 patients who did not.

RESULTS

PVI in 89 patients. Increased levels of aspartate transaminase, tumor markers, size and microvessel tumor infiltration (MVI) or cirrhosis, poorly differentiation, non-adjuvant HAI was associated with lower overall survival (p = 0.09). Poor differentiation, MVI and HAI were independently risk factors associated with tumor-free and overall survivals by the multivariate analysis (p < 0.05). Adjuvant HAI tended to show longer survivals in comparison with no-HAI (p = 0.08) and the multivariate analysis revealed significant efficacy of HAI for better prognosis.

CONCLUSION

Adjuvant HAI showed effectiveness on prolonging tumor-free and patient survival in HCC with PVI and is a promising option in the daily clinical practice.

摘要

背景

辅助性肝动脉内化疗（HAI）被认为是一种很有前途的选择。

方法

我们研究了 37 例接受肝癌切除术且伴有门静脉浸润（PVI）的肝癌（HCC）患者辅助 HAI 使用顺铂的治疗效果，并与 85 例未接受辅助 HAI 的患者进行了比较。

结果

89 例患者伴有 PVI。天冬氨酸转氨酶、肿瘤标志物、大小和微血管肿瘤浸润（MVI）水平升高或伴有肝硬化、分化不良、未接受辅助 HAI 与总生存率降低相关（p=0.09）。多因素分析显示，分化不良、MVI 和 HAI 是无肿瘤和总生存率的独立危险因素（p<0.05）。与无 HAI 相比，辅助 HAI 倾向于显示更长的生存时间（p=0.08），多因素分析显示 HAI 对改善预后具有显著疗效。