原发性肝癌合并门静脉癌栓不同治疗方法的疗效观察

Therapeutic effect of several therapeutic methods for hepatocellular carcinoma with tumor thrombosis in portal vein

目的评价原发性肝癌合并门静脉癌栓不同治疗方法的疗效。方法回顾性分析我院83例原发性肝癌伴门静脉癌栓患者的临床资料,根据不同的治疗方法分为肝癌手术切除+癌栓切除或取出+术后肝动脉化疗栓塞治疗组(A组),肝癌手术切除+癌栓切除或取出治疗组(B组),肝动脉化疗栓塞治疗组(C组)。结果 A组中位生存期17个月,术后0.5、1、3年生存率分别为92.1%、64.6%和19.1%。B组中位生存期12个月,术后0.5、1、3年生存率分别为58.3%、41.7%和7.1%。C组中位生存期5个月,术后0.5、1、3年生存率分别为37.0%、15.9%和0。各组生存率比较,差异均有统计学意义(P<0.05)。结论肝切除和门静脉取栓术是肝癌伴门静脉癌栓的有效治疗方法,术后联合肝动脉化疗栓塞能提高治疗效果,延长患者的生存期。

Objective To evaluate the efficacy of several therapeutic methods for hepa：tocellular carcinoma with portal vein tumor thrombosis. Methods A total of 83 cases of hepatocellular carcinoma with portal vein tumor thrombosis in our hos- pital were retrospectively reviewed, which were divided into three groups according to the different treatment： transcatheter hepatic arterial chemoembolization after operation group （Group A, n= 38）, excision of HCC with removal of portal vein tumor thrombosis group （Group B, n=24）, and transcatheter hepatic arterial ehemoembolization group （Group C, n= 21） . Results The median survival period was 17 in group A, 0.5, 1, 3-year survival rates were 92.1%, 64.6G and 19.1% respectively. The median survival period was 12 in group B, 0.5, 1, 3-year survival rates were 58.3%, 41.7% and 7.1%. The median survival period was 5 in group A, 0.5, 1, 3-year survival rates were 37.0%, 15.9% and 0. The survival rates differed signif- icantly between the 3 groups （P〈0.05）. Conclusion Hepatic resection with removal of tumor thrombosis in the portal vein is effective in the treatment for hepatocellular carcinoma with portal vein tumor thrombosis, and postoperative transarterial chemo- embolization has a favorable effect on the prognosis.