Takagi K, Koyama T, Hasegawa M, Manabe K
Dept. of Surgery, Niigata Prefectural Central Hospital.
Gan To Kagaku Ryoho. 1998 Mar;25(4):597-600.
The effect of hepatic arterial infusion chemotherapy on the prognosis after hepatectomy for hepatocellular carcinoma was investigated in patients with risk factors for recurrence. The risk factors for recurrence after hepatectomy were defined to be metastasis in the liver (+), portal tumor embolus (+), and tumor larger than 5 cm in diameter. Out of 87 patients with hepatocellular carcinoma who underwent an operation in the past 7 years in our hospital, 60 survived for more than 1 year and were enrolled in our study. Thirty-eight of them showed one or more risk factors for recurrence, and were considered to be the high-risk group. These 38 patients were divided into two groups: one group of 19 treated by hepatic arterial infusion chemotherapy using mitoxantrone, and the other group of 19 given no treatment. The survival rates and non-recurrence rates were compared between the two groups. The survival rates after 1 and 3 years for the group treated by hepatic arterial infusion chemotherapy were 94.7% and 54.7%, respectively. The survival rates for the non-treated group were 53.9% and 32.8%, respectively (p = 0.012). The non-recurrence rates after 1 year and 3 years were 94.7% and 44.2% for the treated group and 52.6% and 23.6% for the non-treated group (p = 0.005), respectively. The survival rates and non-recurrence rates after 3 years in the treated group were significantly higher (p = 0.012, 0.005), respectively. It was concluded, therefore, that post-operation hepatic arterial infusion chemotherapy improved the prognosis of the high-recurrence probability group.
对有复发危险因素的肝细胞癌患者,研究了肝动脉灌注化疗对肝切除术后预后的影响。肝切除术后复发的危险因素定义为肝内转移(+)、门静脉癌栓(+)和肿瘤直径大于5cm。在我院过去7年接受手术的87例肝细胞癌患者中,60例存活超过1年并纳入本研究。其中38例有一个或多个复发危险因素,被认为是高危组。这38例患者分为两组:一组19例采用米托蒽醌肝动脉灌注化疗,另一组19例未接受治疗。比较两组的生存率和无复发生存率。肝动脉灌注化疗组1年和3年的生存率分别为94.7%和54.7%。未治疗组的生存率分别为53.9%和32.8%(p = 0.012)。治疗组1年和3年的无复发生存率分别为94.7%和44.2%,未治疗组分别为52.6%和23.6%(p = 0.005)。治疗组3年后的生存率和无复发生存率显著更高(分别为p = 0.012,0.005)。因此,得出结论,术后肝动脉灌注化疗改善了高复发概率组的预后。