中晚期肝细胞肝癌术后行索拉非尼治疗的疗效分析

Efficacy analysis of sorafenib therapy after hepatectomy in treatment of intermediate and advanced hepatocellular carcinoma

目的:探讨手术切除联合索拉非尼治疗中晚期肝细胞肝癌(HCC)的临床疗效。方法:收集2010年1月—2012年6月因中晚期肝癌在四川大学华西医院行手术切除并于术后行索拉非尼治疗的中晚期HCC患者资料(观察组),以及同期仅行手术切除的中晚期HCC患者资料(对照组),行1:2配对病例对照研究,比较两组患者的生存与肿瘤复发情况。结果:共纳入81例患者,其中观察组27例,对照组54例。至随访截止时间(2013年9月30日),观察组与对照组的中位生存时间分别为18.6个月和11.9个月,差异有统计学意义(P=0.014);肿瘤复发时间分别为7.4个月和5.0个月,差异无统计学意义(P=0.291);BCLC B期患者中位生存时间分别为22.3个月和12.5个月,差异有统计学意义(P=0.017),而BCLC C期患者中位生存时间分别为17.6个月和10.4个月,差异无统计学意义(P=0.199)。结论:对于中晚期肝癌患者,尤其是BCLC B期患者,手术切除联合索拉非尼治疗可以取得较为满意的效果,是一种值得考虑的治疗方案。

Objective： To evaluate the clinical efficacy of sorafenib administration combined with liver resection in treatment of intermediate/advanced stage hepatocellular carcinoma （HCC）. Methods： Data of patients with intermediate/advanced stage HCC undergoing liver resection and postoperative sorafenib therapy （observational group） from January 2010 to June 2012, along with the data of patients with intermediate/advanced stage HCC receiving surgical resection only （control group） during the same period at West China Hospital of Sichuan University were collected, for 1-to-2 matched case-control study. The survival and tumor recurrence between the two groups were compared. Results： A total of 81 patients were included, with 27 cases in observational group and 54 cases in control group. In observational group and control group up to the end of follow-up （30 September 2013）, the median survival time was 18.6 and 11.9 months, and the difference had statistical significance （P=0.014）; the median time to recurrence was 7.4 and 5.0 months, and the difference had no statistical significance （P=0.291）; the median survival time for BCLC-B patients was 22.3 and 12.5 months, and the difference had statistical significance （P=0.017）, while for BCLC-C patients was 17.6 and 10.4 months, and the difference had no statistical significance （P=0.291）.Conclusion： Surgical resection plus sorafenib therapy has good efficacy in patients with intermediate/advanced HCC, especially those in BCLC-B stage. So, it is a treatment method deserving consideration.