中晚期肝癌介入化疗术的预后影响因素

Prognostic factors in patients with advanced hepatocellular cancer after transcatheter arterial chemo-embolization

目的 探讨中晚期肝癌介入化疗后的主要预后影响因素 .方法 对 81例行介入化疗的中晚期肝癌病例进行回顾性统计 ,应用 COX比例风险模型对 14项指标进行了多因素分析 ,并用 Kaplan- Meier法计算其生存率 .结果 多变量分析显示 ,影响中晚期肝癌预后最明显的因素是肿瘤大体类型、门静脉癌栓、经手术治疗 ;经肝动脉插管灌注化疗组与经肝动脉插管化疗栓塞组的预后无差异 .本组 6 ,12 ,2 4 ,30 m o生存率分别为 5 8% ,32 % ,15 % ,12 % .结论 中晚期肝癌预后由多种因素决定 .对于肿瘤相对局限、无门静脉癌栓的患者积极行介入化疗术 。

AIM To evaluate the major prognostic factors in advanced hepatocellular carcinoma (HCC) after transcatheter arterial chemoembolization (TACE) and transcatheter arterial infusion chemotherapy (TAI). METHODS Retrospective analysis of 14 factors for prognosis were studied by multivariable analysis with COX proportional hazards survival model in cases of HCC treated by interventional chemotherapy via hepatic artery, and the survival rate was calculated by Kaplan Meier estimation. RESULTS Multivariable analyses revealed significant prognostic factors as follows: tumor gross type, tumor thrombus in the portal vein and subsequent to redical resection. In this series, the survival rate of 6, 12, 24, 30 mon were 58%, 32%, 15%, and 12% respectively. Survival of patients with TACE was similar to that with TAI. CONCLUSION The prognosis of HCC is determined by various factors. For patients with massive form and no tumor thrombus in the portal vein, TACE and TAI are strongly recommended so as to improve the prognosis.