预防性肝动脉栓塞化疗在大肝癌切除术后治疗中的价值

Value of prophylactic transcatheter hepatic arterial chemoembolization after curative resection for large hepatocellular carcinoma

目的 探讨预防性肝动脉栓塞化疗（TACE）在大肝癌（肿瘤总直径≥8cm）治疗中的价值.方法 选取行根治性大肝癌切除术的112例患者,其中术后行TACE79例（TACE组）,未行TACE33例（对照组）.比较分析两组患者术后1、2、3年的累计无瘤生存率及总生存率.结果 TACE组术后1、2、3年的累计无瘤生存率分别为70.9%、48.1%、12.6%,对照组分别为36.4%、20.0%、15.0%.TACE组术后1、2年累计无瘤生存率均明显高于对照组（P＜0.05）,术后3年两组患者累计无瘤生存率无明显差异（P ＞0.05）.TACE组术后1、2、3年的累计总生存率分别为 89.8%、68.1%、41.2%,对照组分别为57.6%、36.4%、29.1%.TACE组术后1、2年累计总生存率均明显高于对照组（P＜0.05）,两组患者术后3年累计总生存率无明显差异（P ＞0.05）.结论 预防性TACE可以提高大肝癌手术切除患者的无瘤生存率及延长生存期,对提高手术效果具有重要意义.

Objective To assess the value of prophylactic transcatheter hepatic arterial chemoembolization （TACE） after curative resection for large hepatocellular carcinoma. Methods One hundred and twelve patients with large hepatocellular carcinoma （diameter i〉 8cm） underwent curative resection, among whom 79 received prophylactic TACE treatment after surgery （TACE group） and 33 had not TACE treatment （non-TACE group）. The 1-, 2-, and 3-y tumor free survival and overall survival rates were compared between two groups. Results The 1-, 2-, and 3-year tumor free survival rates for TACE group and non-TACE group were 70.9%, 48.1%, 12.6% and 36.4%, 20.0%, 15.0%, respectively. There were statistically significant differences in 1- and 2-y tumor free survival between the two groups （P〈0.05）; however, there was no significant difference in 3-y survival （P 〉0.05）. The overall survival rates for TACE group and non-TACE group were 89.8%, 68.1%, 41.2% and 57.6%, 36.4%, 29.1%, respectively. There were statistically significant differences in 1- and 2- y overall survival between two groups （P〈0.05）; but no difference in 3-y overall survival between two groups （P 〉0.05）. Conclusion The study demonstrated that prophylactic TACE treatment after curative resection may increase the tumor free and overall survival for patients with large hepatocellular carcinoma.