肝功能状态对晚期肝癌介入治疗生存期的影响

The effect of hepatic function status on the survival time in patients with advanced hepatocellular carcinoma after transcatheter arterial chemoembolization

目的探讨不同肝功能Child-Pugh分级对晚期肝癌(BCLC-C)TACE治疗生存期的影响。方法回顾性分析TACE治疗的晚期肝癌患者74例。根据术前Child-Pugh分级将患者分成Child-PughA级和B级,Child-Pugh A级患者62例,B级患者12例,术后随访。依据Child-Pugh分级进行相关性生存分析。结果 Child-Pugh A级3、6、9、12和24个月生存率分别为85%、60%、31%、17%和11%,而Child-Pugh B级生存率分别为33%、17%、17%、8%和0%。全组患者中位生存期8.2个月。Child-Pugh A与B级中位生存期分别为8.5、2.5个月(P=0.002)。结论 Child-Pugh A级肝功能进展期肝癌患者,从TACE治疗中能够取得生存获益。

Objective To explore the effect of hepatic function status （Child-Pugh classification） on the survival time in patients with advanced hepatocellular carcinoma after transcatheter arterial chemoembolization （TACE）. Methods TACE was carried out in 74 patients with advanced hepatocellular carcinoma. The clinical data were retrospectively analyzed. Based on the preoperative Child-Pugh grading, the patients were divided into Child-Pugh grade A group （n = 62） and Child-Pugh grade B group （n = 12）. After the treatment all the patients were followed up. The correlation between the survival rate and the Child-Pugh grading was analyzed. Results In Child- Pugh grade A group the survival rates at 3, 6, 9, 12 and 24 months after TACE were 85%, 60%, 31%, 17% and 11% respectively, while in Child-Pugh grade B group the survival rates at 3, 6, 9, 12 and 24 months after TACE were 33%, 17%, 17%, 8% and 0% respectively. The median survival time for all patients was 8.2 months. The median survival time for Child- Pugh grade A group and for Child-Pugh grade B group was 8.5 months （95%CI：7.7, 9.3 months） and 2.5 months （95%CI： 2.4, 2.6months） respectively （P = 0.002）. Conclusion Patients with advanced-stage hepatocellular carcinoma, if their hepatic functions are classified in Child- Pugh grade A, can get more benefit of a longer survival time from TACE.