Ishii H, Okada S, Sato T, Nose H, Okusaka T, Yoshimori M, Takayasu K, Takayama T, Kosuge T, Yamasaki S
National Cancer Center Hospital, Tokyo, Japan.
Hepatogastroenterology. 1996 May-Jun;43(9):644-50.
BACKGROUND/AIMS: This study was conducted to clarify the effect of percutaneous ethanol injection (PEI) in combination with transcatheter arterial embolization (TAE) on prolonging the survival time of patients with postoperative recurrence of hepatocellular carcinoma (HCC).
The subjects were 97 consecutive patients (pts) treated for postoperative recurrent HCC between February 1987 and March 1993. Of these, 25 pts received both TAE and PEI and 72 pts received TAE alone. In the TAE & PEI group, treatment was selected according to the indications: 15 pts received TAE for multiple recurrences following PEI, and the other 10 pts received PEI for a new or residual lesion following TAE. Fourteen demographic, pathological, and clinical variables were evaluated to estimate the relative risk of pts treated with TAE & PEI or with TAE alone.
The 1-, 3- and 5- year survival rates in the TAE & PEI group were 100%, 73.2% and 27.2%, respectively, and those in the TAE alone group were 88.9%, 30.2% and 5.5%, respectively. Based on multi-variate Cox regression analysis, the relative risk of cancer death in the TAE & PEI group was 0.32 (95% confidence interval, 0.15 to 0.67).
The combination of TAE and PEI had a positive palliative effect and increased survival time of patients with postoperative recurrent HCC, compared to results obtained by TAE alone.
背景/目的:本研究旨在阐明经皮乙醇注射(PEI)联合经导管动脉栓塞术(TAE)对延长肝细胞癌(HCC)术后复发患者生存时间的影响。
研究对象为1987年2月至1993年3月间连续治疗的97例术后复发性HCC患者。其中,25例患者接受了TAE和PEI治疗,72例患者仅接受了TAE治疗。在TAE & PEI组中,根据适应证选择治疗方法:15例患者在PEI后因多次复发接受TAE治疗,另外10例患者在TAE后因新发病灶或残留病灶接受PEI治疗。评估了14个人口统计学、病理和临床变量,以估计接受TAE & PEI或仅接受TAE治疗患者的相对风险。
TAE & PEI组的1年、3年和5年生存率分别为100%、73.2%和27.2%,仅TAE组的生存率分别为88.9%、30.2%和5.5%。基于多变量Cox回归分析,TAE & PEI组癌症死亡的相对风险为0.32(95%置信区间,0.15至0.67)。
与单独使用TAE的结果相比,TAE和PEI联合使用对术后复发性HCC患者具有积极的姑息治疗效果,并延长了患者的生存时间。