术后辅助性经动脉化疗栓塞可改善巨大肝细胞癌患者的预后。
Postoperative adjuvant transcatheter arterial chemoembolization improves the prognosis of patients with huge hepatocellular carcinoma.
作者信息
Wang Han, Yu Hua, Qian You-Wen, Cao Zhen-Ying, Wu Meng-Chao, Cong Wen-Ming
机构信息
Department of Pathology, Eastern Hepatobiliary Surgery Hospital, The Second Military Medical University, Yangpu, Shanghai 200438, China.
Department of Hepatic Surgery, Eastern Hepatobiliary Surgery Hospital, The Second Military Medical University, Shanghai 200438, China.
出版信息
Hepatobiliary Pancreat Dis Int. 2021 Jun;20(3):232-239. doi: 10.1016/j.hbpd.2020.12.018. Epub 2021 Jan 5.
BACKGROUND
Surgical resection of huge hepatocellular carcinoma (HCC, ≥ 10 cm) is potentially curative. More adjuvant treatments are needed to reduce relapses in these patients. We evaluated the influence of postoperative adjuvant transcatheter arterial chemoembolization (PA-TACE) on the prognosis of huge HCC.
METHODS
Data from consecutive patients who underwent curative resection for huge HCC in our center were retrospectively collected. Recurrence-free survival (RFS) and overall survival (OS) were compared between patients who did and did not undergo PA-TACE. Propensity score matching (PSM) was used.
RESULTS
Among the 255 enrolled patients, 93 underwent PA-TACE. The clinical outcomes were significantly better in the PA-TACE group than those in the non PA-TACE group (5-year RFS rate: 33.5% vs. 18.0%; 5-year OS rate: 47.0% vs. 28.0%, all P < 0.001). After PSM, similar results were obtained (5-year RFS rate: 28.8% vs. 17.6%, P < 0.001; 5-year OS rate: 42.5% vs. 25.0%, P = 0.004). PA-TACE decreased the possibility of early recurrence (< 2 years, crude cohort: P < 0.001, PSM cohort: P < 0.001) but not late recurrence (≥ 2 years, crude cohort: P = 0.692, PSM cohort: P = 0.325). Multivariable Cox regression analysis suggested that PA-TACE was an independent protective factor prolonging early RFS, RFS and OS.
CONCLUSIONS
PA-TACE is a safe intervention for huge HCC patients after liver resection and improves outcomes.
背景
手术切除巨大肝细胞癌（HCC，≥10 cm）可能治愈。需要更多辅助治疗以减少这些患者的复发。我们评估了术后辅助经动脉化疗栓塞术（PA-TACE）对巨大HCC预后的影响。
方法
回顾性收集在本中心接受巨大HCC根治性切除的连续患者的数据。比较接受和未接受PA-TACE的患者的无复发生存期（RFS）和总生存期（OS）。采用倾向评分匹配（PSM）。
结果
在255例入组患者中，93例接受了PA-TACE。PA-TACE组的临床结局显著优于非PA-TACE组（5年RFS率：33.5%对18.0%；5年OS率：47.0%对28.0%，所有P<0.001）。PSM后，获得了相似的结果（5年RFS率：28.8%对17.6%，P<0.001；5年OS率：42.5%对25.0%，P=0.004）。PA-TACE降低了早期复发（<2年，粗队列：P<0.001，PSM队列：P<0.001）的可能性，但未降低晚期复发（≥2年，粗队列：P=0.692，PSM队列：P=0.325）的可能性。多变量Cox回归分析表明，PA-TACE是延长早期RFS、RFS和OS的独立保护因素。
结论
PA-TACE对巨大HCC肝切除术后患者是一种安全的干预措施，并可改善结局。
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