影响中晚期原发性肝癌远期疗效的因素——以肝动脉化疗栓塞术为主的多模式治疗

A Prognostic Index of the Survival of Patients with Primary Liver Cancer after Multimodality Treatment Including Transcatheter Arterial Chemoembolization

目的 评价影响中晚期原发性肝癌 (以肝动脉化疗栓塞术 (TACE)为主的多模式治疗 )远期疗效的因素。方法 对曾采用TACE在内的多模式治疗的 89例中晚期原发性肝癌 ,选择 15个变量 ,行Cox回归模型分析影响远期疗效的因素。结果 单因素Cox回归模型分析结果显示肿瘤在肝内侵犯范围、肿瘤直径、组织类型及TACE次数有显著意义 (P <0 0 5 )。Kaplan Meier法计算累积中位生存期为 45个月 ,1～ 5年生存率分别为 :77 0 6 %、6 3 31%、5 1 6 9%、2 3 19%、14 5 9%。单纯TACE组总的生存率 ,长于手术 +TACE组 (P <0 0 5 )。结论 多因素分析和单因素分析均包含了肿瘤在肝内侵犯范围和肿瘤直径两项因素 。

Objective To determine the prognostic factors for primary liver cancer (PLC) after transcatheter chemoembolization (TACE) that was included in multimodality treatment. Methods 89 patients who underwent multimodality treatment for PLC from 1994—1999 were included for Cox′s univariate and multivariate analysis.15 factors contributed to the long\|term survival rate (SR) were analyzed. Results According to univariate analysis of Cox's model,variables significantly associated with SR were the extension of tumor in liver,staging of tumor,TACE,the tumor size and involvement of lymph nodes ( P <0 05).However,extension of tumor in liver,the tumor size,the pathological type of tumor and the times of TACE were independent factors in multivariate analysis for the long\|term SR( P <0 05).Kaplan\| Meier method proved the median survival period was 45 months.Cumulative SRs at 1,2,3,4,5 years were 77 06%,63 31%,51 69%,23 19% and 14 59%,respectively.Overall SR was significantly higher in the group of TACE than in the group of TACE after surgical resection ( P <0 05). Conclusion The extension of tumor in liver and the tumor size were the determing prognostic factors. [