经DDS化疗对肝癌切除术后复发的影响

Effect of DDS Chemotherapy to Recurrence After Radical Excision for Hepatic Carcinoma

目的探讨经肝动脉和(/或)门静脉DDS化疗对肝癌术后复发的影响。方法1998年1月至2004年12月共收治原发性肝癌801例,其中行根治性切除,术后未行DDS化疗且有完整随访资料者78例(对照组),行DDS化疗的有完整随访资料者325例(DDS组)。结果对照组1年内复发(早期复发)54例(69.2%),1年后复发(晚期复发)18例(23.1%),而DDS组1年内复发113例(34.8%),1年后复发107例(32.9%)。早期复发两组存在着显著性差异(P<0.05),而晚期复发两组无显著差异(P>0.05)。门静脉癌栓、卫星灶是肝癌早期复发的重要因素,前白蛋白≤160 g/L、白蛋白≤30 g/L与晚期复发有关。结论DDS化疗对预防肝癌的早期复发起一定的作用,但对晚期复发无影响。

Objective To evaluate the effect of DDS chemotherapy to recurrence after radical hepatectomy for hepatic carcinoma. Methods From January 1998 to December 2004, 801 cases of liver cancer were hospitalized. In the patients underwent radical hepatectomy with complete follow-up data, 78 cases were classified into control group without DDS chemotherapy, and 325 cases were classified into DDS group with DDS chemotherapy. Results The patients recurred in one and after year were 54 （69.2%） and 18 （ 23.1% ） respectively in the control group, and 113 （34.8%） and 107 （32.9%） respectively in the DDS group. There was significant difference between the two groups in the early recurrence （within one year） （P 〈 0.05 ）, but no significant difference in later recurrence （ after one year） （ P 〉 0.05 ）. Tumor thrombosis in portal vein and satellite focus were the important factors in early recurrence of hepatic carcinoma, while prealbumin ≤ 160g/L and albumin ≤30g/L were relevant to the later recurrence. Conclusions DDS chemotherapy plays an important role to preventing early recurrence, but does not influence the later recurrence after radical hepatectomy for hepatic carcinoma.