不可切除的肝细胞癌：经导管治疗的预后因素分析
Unresectable hepatocellular carcinoma: analysis of prognostic factors in transcatheter management.
作者信息
Hatanaka Y, Yamashita Y, Takahashi M, Koga Y, Saito R, Nakashima K, Urata J, Miyao M
机构信息
Department of Radiology, Kumamoto University School of Medicine, Japan.
出版信息
Radiology. 1995 Jun;195(3):747-52. doi: 10.1148/radiology.195.3.7754005.
PURPOSE
To evaluate the effect of transcatheter management of hepatocellular carcinoma (HCC) on survival.
MATERIALS AND METHODS
A prospective trial of transcatheter arterial embolization (TAE) was performed in patients with unresectable HCC. Three hundred twenty-two patients (265 men, 57 women; age range, 30-83 years) underwent TAE alone: 60 patients underwent TAE with gelatin sponge (GS) that contained anticancer agents (protocol 1); 78, TAE with GS and iodized oil mixed with anticancer agents (protocol 2); and 159, TAE with iodized oil with anticancer agents (protocol 3). A Cox proportional hazard model was used to analyze prognostic factors.
RESULTS
In the randomized group (n = 272), survival rates for protocols 1, 2, and 3 were 80.4%, 86.3%, and 65.9%, respectively, at 1 year. Findings of analysis of prognostic factors showed that extrahepatic metastases, ascites, tumor extension, and icterus were the important factors.
CONCLUSION
TAE with GS was superior to TAE without GS. Patient characteristics were important factors for survival.
目的
评估经导管治疗肝细胞癌（HCC）对生存率的影响。
材料与方法
对无法切除的HCC患者进行经导管动脉栓塞术（TAE）的前瞻性试验。322例患者（265例男性，57例女性；年龄范围30 - 83岁）单纯接受TAE：60例患者接受含抗癌药物的明胶海绵（GS）TAE（方案1）；78例接受GS与碘化油混合抗癌药物的TAE（方案2）；159例接受含抗癌药物碘化油的TAE（方案3）。采用Cox比例风险模型分析预后因素。
结果
在随机分组的272例患者中，方案1、2和3在1年时的生存率分别为80.4%、86.3%和65.9%。预后因素分析结果显示，肝外转移、腹水、肿瘤侵犯和黄疸是重要因素。
结论
含GS的TAE优于不含GS的TAE。患者特征是生存的重要因素。
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