肝切除与经动脉化疗栓塞术治疗合并胆管癌栓的肝细胞癌患者的预后比较：一项倾向评分匹配分析
Prognostic Comparison Between Liver Resection and Transcatheter Arterial Chemoembolization for Hepatocellular Carcinoma Patients With Bile Duct Tumor Thrombus: A Propensity-Score Matching Analysis.
作者信息
Liu Zong-Han, Sun Ju-Xian, Feng Jin-Kai, Yang Shi-Ye, Chen Zhen-Hua, Liu Chang, Chai Zong-Tao, Mao Fei-Fei, Guo Wei-Xing, Shi Jie, Cheng Shu-Qun
机构信息
Department of Hepatic Surgery VI, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai, China.
Department of General Surgery, Zhejiang Provincial Armed Police Corps Hospital, Hangzhou, China.
出版信息
Front Oncol. 2022 Mar 15;12:835559. doi: 10.3389/fonc.2022.835559. eCollection 2022.
BACKGROUND
Hepatocellular carcinoma (HCC) with bile duct tumor thrombus (BDTT) is rare. The aim of this study is to evaluate the long-term prognosis of liver resection (LR) versus transcatheter arterial chemoembolization (TACE) in these patients.
METHODS
Data from HCC patients with BDTT who underwent liver resection and TACE were analyzed respectively. Propensity score matching (PSM) analysis was performed in these patients.
RESULTS
A total of 145 HCC patients with BDTT were divided into two groups: the LR group (n = 105) and the TACE group (n = 40). The median OS in the LR group was 8.0 months longer than that in the TACE group before PSM (21.0 vs. 13.0 months, P <0.001) and 9.0 months longer after PSM (20.0 vs. 11.0 months, P <0.001). The median DFS in the LR group was 3.5 months longer than that in the TACE group before PSM (7.0 vs. 3.5 months, P = 0.007) and 5 months longer after PSM (7.0 vs. 2.0 months, P = 0.007).
CONCLUSION
If surgery is technically feasible, liver resection provides better prognosis for HCC patients with BDTT compared with TACE.
背景
伴有胆管癌栓（BDTT）的肝细胞癌（HCC）较为罕见。本研究旨在评估肝切除术（LR）与经动脉化疗栓塞术（TACE）对这些患者的长期预后。
方法
分别分析接受肝切除术和TACE的伴有BDTT的HCC患者的数据。对这些患者进行倾向评分匹配（PSM）分析。
结果
145例伴有BDTT的HCC患者被分为两组：肝切除组（n = 105）和TACE组（n = 40）。PSM分析前，肝切除组的中位总生存期比TACE组长8.0个月（21.0对13.0个月，P <0.001），PSM分析后长9.0个月（20.0对11.0个月，P <0.001）。PSM分析前，肝切除组的中位无病生存期比TACE组长3.5个月（7.0对3.5个月，P = 0.007），PSM分析后长5个月（7.0对2.0个月，P = 0.007）。
结论
如果手术在技术上可行，与TACE相比，肝切除术可为伴有BDTT的HCC患者提供更好的预后。
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