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经动脉化疗栓塞术与射频消融术联合应用后患者肝细胞癌直径的统计学技术分类及预后评估

Classification of hepatocellular carcinoma diameter by statistical technology and prognostic evaluation in patients after the combined use of transarterial chemoembolization and radiofrequency ablation.

作者信息

Cao Yanyan, Ren Yanqiao, Ma Hong, Zhou Chen, Liu Jiacheng, Shi Qin, Feng Gansheng, Zheng Chuansheng, Xiong Bin

机构信息

Department of Radiology, Tongji Medical College, Union Hospital, Huazhong University of Science and Technology; Hubei Province Key Laboratory of Molecular Imaging, Wuhan, Hubei, China.

Cancer Center, Tongji Medical College, Union Hospital, Huazhong University of Science and Technology, Wuhan, Hubei, China.

出版信息

J Cancer Res Ther. 2020;16(2):356-364. doi: 10.4103/jcrt.JCRT_648_19.

DOI:10.4103/jcrt.JCRT_648_19
PMID:32474524
Abstract

OBJECTIVE

This study aimed to classify hepatocellular carcinomas (HCCs) according to their diameter using statistic technology and evaluate the prognosis of the classified groups after the combined use of transarterial chemoembolization (TACE) and radiofrequency ablation (RFA).

MATERIALS AND METHODS

Electronic medical records of 128 consecutive patients who underwent TACE-RFA as the initial treatment for HCC from January 2010 to April 2018 were retrospectively analyzed. TACE was initially performed with subsequent RFA performed after 3-7 days. The decision tree model was used to classify overall survival (OS), progression-free survival (PFS), local recurrence rate (LRR), and treatment complications in HCC.

RESULTS

The tumors were divided into three groups of sizes ≤2.9 cm, 2.9-4.8 cm, and >4.8 cm. The group of tumors >4.8 cm showed inferior OS, PFS, and LRR than the other two groups (P < 0.05) on long-term follow-up but not in thefirst 6 months (P > 0.05). The groups of tumors ≤2.9 cm and 2.9-4.8 cm showed no statistically significant difference in OS, PFS, and LRR (P > 0.05).

CONCLUSIONS

The cutoff points of 2.9 and 4.8 cm were achieved using the objective decision tree model rather than the artificial division of 3 and 5 cm. The prognosis was not significantly different between the groups of tumors ≤2.9 cm and 2.9-4.8 cm, and the prognosis of the two groups was better than the group of tumors >4.8 cm in the long-term follow-up but not in thefirst 6 months.

摘要

目的

本研究旨在运用统计技术根据肝细胞癌(HCC)的直径进行分类,并评估经动脉化疗栓塞术(TACE)与射频消融术(RFA)联合应用后各分类组的预后情况。

材料与方法

回顾性分析2010年1月至2018年4月期间连续128例接受TACE-RFA作为HCC初始治疗的患者的电子病历。首先进行TACE,随后在3-7天后进行RFA。采用决策树模型对HCC的总生存期(OS)、无进展生存期(PFS)、局部复发率(LRR)和治疗并发症进行分类。

结果

肿瘤被分为三组,大小分别为≤2.9 cm、2.9-4.8 cm和>4.8 cm。在长期随访中,肿瘤>4.8 cm组的OS、PFS和LRR均低于其他两组(P<0.05),但在最初6个月时差异无统计学意义(P>0.05)。肿瘤≤2.9 cm组和2.9-4.8 cm组在OS、PFS和LRR方面差异无统计学意义(P>0.05)。

结论

使用客观的决策树模型得出的截断点为2.9 cm和4.8 cm,而非人为划分的3 cm和5 cm。在长期随访中,肿瘤≤2.9 cm组和2.9-4.8 cm组的预后差异无统计学意义,且两组的预后均优于肿瘤>4.8 cm组,但在最初6个月时并非如此。

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