Barcelona临床肝癌分期B期亚分期肝细胞癌患者TACE术后生存分析

Survival analysis of patients with different sub-stages of Barcelona clinic liver cancer classification stage B hepatocellular carcinoma after TACE

目的探讨Barcelona临床肝癌(BCLC)分期B期亚分期的必要性,分析不同亚分期肝细胞癌(HCC)患者TACE术后疗效及生存情况。方法回顾性分析133例接受TACE治疗的BCLC B期HCC患者的临床及随访资料,包括B1期31例,B2期77例,B3期15例,B4期10例,评价TACE疗效及生存情况。结果 133例患者共接受567次TACE治疗,不同亚分期HCC患者间TACE治疗次数差异无统计学意义(F=1.702,P=0.170)。首次TACE术后1个月,根据改良实体肿瘤疗效评价标准,部分缓解47例,稳定74例,进展12例。不同亚分期HCC患者间疗效差异无统计学意义(χ~2=2.121,P=0.908)。不同亚分期HCC患者TACE术后总生存时间差异有统计学意义(χ~2=10.846,P=0.013),B1期患者生存时间明显长于B3期(P=0.020)及B4期(P=0.033)患者。结论 BCLC B期各亚分期HCC患者TACE术后总生存时间不同,进行亚分期有助于临床制定更有针对性的治疗方案。

Objective To investigate the necessity of sub-classification for Barcelona clinic liver cancer (BCLC) classification stage B hepatocellular carcinoma (HCC),and to analyze the curative effect and survival of patients with different substages HCC after TACE.Methods Clinical and follow-up data of 133 patients with BCLC classification stage B HCC treated with TACE were retrospectively analyzed.There were 31 cases of substage B1,77 of substage B2,15 of substage B3 and 10 cases of substage B4.The curative effect and survival of patients were evaluated.Results Totally 567 times of TACE treatments were performed on 133 patients.There was no statistical difference of the TACE treatment times among patients with different substages ( F =1.702,P =0.170).One month after the first time TACE,partial response was achieved in 47 cases,while stable disease and progressive disease were found in 74 cases and 12 cases respectively according to modified response evaluation criteria in solid tumors criteria.No statistical difference of curative effect was detected among patients with different substages (χ^2 =2.121,P =0.908).The overall survival of patients with different substages HCC after TACE was statistically different (χ^2 = 10.846,P =0.013).The survival time of patients with substage B1 was significantly longer than that of patients with substage B3 ( P =0.020) and B4 ( P =0.033),respectively.Conclusion The overall survival of patients with BCLC classification stage B HCC after TACE are different.This sub-classification is beneficial for clinic to formulate specific treatment plan.