肝癌术后复发高危患者行TACE的意义

Significance of postoperative transcatheter arterial chemoembolization in high-risk patients with hepatocellular carcinoma

目的 探讨预防性经皮肝动脉化疗栓塞（transeatheter arterial chemoembolization,TACE）在防治高危患者术后复发中的意义.方法 回顾性分析54例有癌栓、子灶或合并多发结节、术后高AFP高危肝细胞癌患者,所有患者由同组手术医师手术,达到根治性切除手术要求.42例患者术后1～2月复查肝功能达到Child A级、肝炎病毒复制被控制在1000 copies/ml以下的高危患者行TACE术做为目标组.12例同样接受根治性手术治疗的高危患者因其他原因未接受TACE治疗做为对照组.通过2年的随访,比较2组的复发率,以了解术后TACE与高危患者复发的关系.结果 接受预防性TACE者术后1年肝内复发率（19.0%）明显低于未接受者（50%） 术后2年复发率同样明显低于未接受者（52.3%vs 83.3%）.对不同时间段复发率进行分析,随着时间延长TACE组复发率逐渐增高接近对照组.结论 对于肝癌高危复发患者术后进行预防性TACE有助于减少术后近期肿瘤复发率.

Objective To investigate the effect of postoperative prophylactic transcatheter arterial Chemoembolization（TACE） on preventing recurrence in 54 high-risk patients with hepatocellular carcinoma.Methods These 54 HCC cases were greded as high risk for recurrence and put on close follow up after radical resection.Risk factors included tumor thrombus,cancer satellite or multiple cancer nodules,postoperative high AFP level.Among them 42 cage （target group） received TACE,in which liver function was of Child A,and hepatitis virus replication was controlled in 1000 copies/ml.12 cases（centrol group） didn＇t receive TACE.The recurrent rate of HCC was compared between the cases with prophylactic TACE and those without through two years of follow-up. Result The recurrence rate of HCC was significantly lower in the cases with prophylactic TACE（19.O%） than those without（50%） within 1 year after the radical operation,and 2 years （52.3% vs 83.3%）. Conclusion Postoperative TACE contributes to reducing the short-term HCC recurrence rate.