切除术前、后辅助性肝动脉栓塞化疗对巨块型肝癌预后的影响

THE SIGNIFICANCE OF POST- OR PREOPERATIVEADJUVANT TRANSCATHETER ARTERIALCHEMOEMBOLIZATION IN THE PROGNOSIS OFPATIENTS WITH LARGE HEPATOCELLULAR

目的研究术前和术后辅助性肝动脉栓塞化疗对肿瘤直径为8 cm以上的巨块型肝癌病人切除术后的影响.方法采用病例对照研究的方法,将本所1995～1998年的病例资料,用Kaplan-Meier方法研究单纯切除术病人,术后辅助性肝动脉栓塞化疗,术前辅助性肝动脉栓塞化疗病人生存曲线.Log-rank方法比较各生存曲线的差别.结果单纯切除组病人、术后辅助性肝动脉栓塞化疗、和术前辅助性肝动脉栓塞化疗病人的中位生存期分别为17.0月,33.0月,和49.0月(P=0.011).结论提示术前辅助性肝动脉栓塞化疗效果优于术后辅助性肝动脉栓塞化疗的结果.对于肿瘤直径在8cm的肝癌,应该在术前或术后给予辅助性肝动脉栓塞化疗.

ve To understand the significance of post-or pretoperative adjuvant transcatheter arterial chemoembolization in the prognosis of patients with large hepatocellular carcinoma.Methods One hundred and sixty seven patients with hepatocellularcarcinoma (≥8 cm)treated in authors'Institute from 1995 to 1998were analyzed.They were divided into three groups:resection only(group 1),with post-(group 2)or preoperative(group 3)adjuvant transcatheter arterial chemoembolization. Case control analysis and Kaplan-Meier method were used to study survival curve,Log-rankmethod was used to compare the difference among the groups.Results The median survival of group 1,2 and 3 was 17.0months.23.0 months,and 49.0 months respectively. Thedifference was statistically significant(P=0.011).ConclusionBoth post-and preoperative adjuvant transcatheter arterialchemoembolization are able to prolong the survival of patients withlarge volume tumor and the preoperative one seems to be superior tothe postoperative one.