Hu Yi-Di, Zhang Hui, Tan Wei, Li Zhuo-Kai
Department of Surgery, Wenzhou TCM Hospital of Zhejiang Chinese Medical University, Wenzhou 325000, Zhejiang Province, China.
Department of Hepatobiliary and Pancreatic Surgery, Lishui Municipal Central Hospital, Lishui 323000, Zhejiang Province, China.
World J Gastrointest Surg. 2023 Dec 27;15(12):2820-2830. doi: 10.4240/wjgs.v15.i12.2820.
Primary hepatocellular carcinoma (HCC) is a common malignant tumour, and its early symptoms are often not obvious, resulting in many patients experiencing middle- to late-stage disease at the time of diagnosis. The optimal time for surgery is often missed for these patients, and those who do undergo surgery have unsatisfactory long-term outcomes and a high recurrence rate within five years. Therefore, postoperative follow-up treatments, such as transhepatic arterial chemoembolization (TACE), have become critical to improving survival and reducing recurrence rates.
To validate the prophylactic role of TACE after hepatic resection and to assess its impact on patient prognosis.
This study investigated the efficacy of TACE in patients with intermediate-stage HCC after hepatectomy. When the post-treatment results of the observation group and the control group were compared, it was found that the inclusion of TACE significantly improved the clinical efficacy, reduced the levels of tumour markers and did not aggravate the damage to liver function. Thus, this may be an effective and comprehensive treatment strategy for patients with intermediate-stage HCC that helps to improve their quality of life and survival time.
When the baseline data were analysed, no statistical differences were found between the two groups in terms of gender, age, hepatitis B virus, cirrhosis, Child-Pugh grading, number of tumours, maximum tumour diameter and degree of tumour differentiation. The assessment of clinical efficacy showed that the post-treatment overall remission rate of the observation group was significantly higher than that of the control group. In terms of changes in tumour markers, the alpha-fetoprotein and carcinoembryonic antigen levels in the patients in the observation group decreased more significantly after treatment compared with those in the control group. When post-treatment changes in liver function indicators were analysed, no statistical differences were found in the total bilirubin, alanine aminotransferase and aspartate aminotransferase levels between the two groups.
In patients with intermediate-stage HCC, post-hepatectomy TACE significantly improved clinical outcomes, reduced tumour-marker levels and may have improved the prognosis by removing residual lesions. Thus, this may be an effective and comprehensive treatment strategy for patients with intermediate-stage HCC.
原发性肝细胞癌（HCC）是一种常见的恶性肿瘤，其早期症状往往不明显，导致许多患者在确诊时已处于中晚期。这些患者常常错过最佳手术时机，而接受手术治疗的患者长期预后不理想，五年内复发率高。因此，术后经肝动脉化疗栓塞术（TACE）等后续治疗对于提高生存率和降低复发率至关重要。
验证肝切除术后TACE的预防作用，并评估其对患者预后的影响。
本研究调查了TACE对中期HCC患者肝切除术后的疗效。比较观察组和对照组的治疗后结果发现，加入TACE可显著提高临床疗效，降低肿瘤标志物水平，且不会加重肝功能损害。因此，这可能是一种有效的综合治疗策略，有助于提高中期HCC患者的生活质量和生存时间。
分析基线数据时，两组在性别、年龄、乙型肝炎病毒、肝硬化、Child-Pugh分级、肿瘤数量、最大肿瘤直径和肿瘤分化程度方面均无统计学差异。临床疗效评估显示，观察组治疗后的总体缓解率显著高于对照组。在肿瘤标志物变化方面，观察组患者治疗后的甲胎蛋白和癌胚抗原水平较对照组下降更为显著。分析治疗后肝功能指标变化时，两组的总胆红素、谷丙转氨酶和谷草转氨酶水平均无统计学差异。
对于中期HCC患者，肝切除术后TACE显著改善了临床结局，降低了肿瘤标志物水平，可能通过清除残留病灶改善了预后。因此，这可能是一种有效的综合治疗策略。
