手术切除和介入治疗原发性肝癌

COMPARISON OF SURVIVAL RATES AFTER ARTERIAL EMBOLIZATION AND SURGICAL RESECTION FOR TREATING SOLITARY HEPATOCELLULAR CARCINOMA

目的对比分析手术根治切除和动脉栓塞治疗原发性肝癌的临床效果。方法对比分析2008年1月至2009年四月住院治疗根治性手术切除和动脉栓塞治疗的原发性肝癌患者临床疗效。结果总共94例患者进入研究,其中手术切除组45例,动脉栓塞组49例。两组年龄、性别和肿瘤直径等基本特征具有可比性。手术切除组1瘤灶根除率100%,栓塞组为22.4%,组间比较差异具有显著性(P<0.01)。手术切除与动脉栓塞1年生存率无显著差异,为86.3%vs 74.3%(P>0.05),但手术组带瘤生存率(12.8%)显著低于栓塞组(82.9%)(P<0.05)。1年复发率手术组(24.4%)显著低于栓塞组(45.5%)(P<0.05)。复发患者中,栓塞组患无瘤生存期低于手术组(6.1±2.7)m vs(10.6±4.3)m(P<0.05)。手术组术后AFP明显优于动脉栓塞组。手术组总并发症发生率(35.6%)与栓塞组(34.7%)无显著差异(P>0.05),均未出现难于控制的并发症。结论动脉栓塞与根治性手术切除治疗HCC1年生成率无明显差异,但是瘤灶根除水平、1年复发和带瘤生存等指标明显优于动脉栓塞,因此其远期效果应优于动脉栓塞。

Ojective This study analyzes the authors′results with arterial embolization or surgical resection for the treatment of solitary hepatocellular carcinomas（HCC）.Methods Analysis of all patients undergoing either surgical resection or embolization combined with local ablation for solitary HCC between January 2008 and April 2009 was performed.Progression-free survival rate and overall survival rate for 1 year were calculated.Results There were 45 patients who underwent surgical resection and 49 patients who underwent embolization.Age,gender,and size of the treated lesion were not significantly different between the groups.The surgical group had a longer median recurrence-free survival rate（6.1±2.7 vs 10.6±4.3 months,P0.05）.With a median follow-up of 12 months,the 1-year actuarial overall survival rates were 74.3% for the embolization group and 86.3% for the surgical group,respectively.There was no statistical difference in overall survival rates（P0.05）,but the survival rates were 12.8% for the surgical group and 82.9% for the embolization group,and there was different significantly（P0.01）.Conclusion Bland arterial embolization is effective in treating solitary HCC and achieves similar overall survival rates to surgical resection for 1 year,but surgical treatment may be more effective over 1 year.