Cun Jiangping, Xu Yonghui, Li Weidong, Zhao Xingxiang
Department of Radiology, The Second Affiliated Hospital, Kunming Medical University, 374 dianmian Avenue, Kunming, Yunnan, China.
J Interv Med. 2021 Feb 27;4(2):66-70. doi: 10.1016/j.jimed.2021.02.008. eCollection 2021 May.
The purpose of this study was to investigate the prognostic factors for transcatheter arterial chemoembolization (TACE) for hepatitis B-related hepatocellular carcinoma (HCC).
The variables that may affect overall survival (OS), such as age, gender, AFP, Child Pugh classification, body mass index, HBV-DNA, HbeAg, tumor number, tumor diameter, BCLC stage, embolization method, ablation therapy, and targeted therapy, were analyzed by single factor and many factor COX regression. In addition, predictive factors of OS were stratified and a Kaplan-Meier survival curve was drawn.
Among the 136 patients, the median follow-up time was 14.5 months (range: 2-72 months). HCC patients with the tumor diameter <3 cm had the highest survival rate, followed by patients with a tumor diameter of 3-5 cm; the survival rate of patients with the tumor diameter (greater than 5 cm) was the lowest. Among the BCLC stages, stage A patients had the highest survival rate, followed by stage B and stage C patients, which had the lowest survival rate.The survival rate of Child Pugh grade A patients was higher than those with Child Pugh grade B. Compared with patients who did not undergo ablation treatment, the survival rate of patients with combined ablation treatment was relatively high. The survival rate of patients receiving drug-eluting beads transarterial chemoembolization (DEB-TACE) treatment was higher than those receiving conventional transarterial chemoembolization (cTACE) treatment. Additionally, repeated TACE treatment improved the OS rate of patients. These six factors were related to patient prognosis and the differences were statistically significant (P < 0.05).
Tumor diameter, BCLC stage, TACE repetition, and TACE combined with ablation were independent prognostic factors of OS.
本研究旨在探讨经动脉化疗栓塞术（TACE）治疗乙型肝炎相关肝细胞癌（HCC）的预后因素。
通过单因素及多因素COX回归分析可能影响总生存期（OS）的变量，如年龄、性别、甲胎蛋白（AFP）、Child Pugh分级、体重指数、乙肝病毒脱氧核糖核酸（HBV-DNA）、乙肝e抗原（HbeAg）、肿瘤数量、肿瘤直径、巴塞罗那临床肝癌（BCLC）分期、栓塞方法、消融治疗及靶向治疗。此外，对OS的预测因素进行分层并绘制Kaplan-Meier生存曲线。
136例患者中，中位随访时间为14.5个月（范围：2 - 72个月）。肿瘤直径<3 cm的HCC患者生存率最高，其次是肿瘤直径为3 - 5 cm的患者；肿瘤直径>5 cm的患者生存率最低。在BCLC分期中，A期患者生存率最高，其次是B期和C期患者，C期患者生存率最低。Child Pugh A级患者的生存率高于Child Pugh B级患者。与未接受消融治疗的患者相比，联合消融治疗患者的生存率相对较高。接受载药微球经动脉化疗栓塞术（DEB-TACE）治疗的患者生存率高于接受传统经动脉化疗栓塞术（cTACE）治疗的患者。此外，重复TACE治疗提高了患者的OS率。这六个因素与患者预后相关，差异具有统计学意义（P<0.05）。
肿瘤直径、BCLC分期、TACE重复次数以及TACE联合消融是OS的独立预后因素。
