经肝动脉化疗栓塞术治疗中晚期肝癌的预后因素分析

Analysis on prognostic factors in transcatheter hepatic arterial chemoembolization in treatment for advanced liver cancer

目的分析影响TACE治疗中晚期肝癌生存期的因素。方法回顾性分析67例中晚期肝癌接受TACE术患者的临床资料,采用Kaplan-Meier及Log-rank分析影响预后的因素,Cox比例风险回归模型进行多因素分析。结果全组患者中位生存期12个月(95%CI:7.82,16.17),1、2、3年生存率分别为44.78%(30/67)、13.43%(9/67)和5.97%(4/67)。单因素预后分析显示:既往有无射频治疗、有无动静脉瘘、BCLC分期、有无门静脉癌栓、ECOG评分、远处转移、ALT、后继索拉菲尼治疗情况与中晚期肝癌患者的预后有关(P<0.05);多因素预后分析显示远处转移及门静脉癌栓与中晚期肝癌患者预后有关(B>0,P<0.05)。结论合并远处转移及门脉癌栓是中晚期肝癌患者预后的独立影响因素。

Objective To analyze the prognostic factors in TACE treatment for advanced liver cancer survival.MethodsClinical data of 67 advanced patients with liver cancer treated by TACE were analyzed retrospectively.The single influenced prognostic factor was analyzed by Kaplan-Meier and Log-rank,and the multivariate analysis on Cox’s proportional hazard regression model was conducted.Results Survival time was 12 months for all patients（95%CI：7.82,16.17）,the rates for surviving on l,2,3years were 44.78%（30/67）,13.43%（9/67）and 5.97%（4/67）,respectively.The single factor analysis showed that additional radio frequency treatment,arteriovenous fistula,BCLC staging,portal vein tumor thrombus,ECOG score,distant metastasis,ALT,subsequent treatment with Sola Feeney were statistically related to the prognosis in patients with advanced liver cancer（P〈0.05）,multivariate analysis revealed that distant metastasis associated with portal vein tumor thrombus was significant influenced factor on prognosis（B〈0,P〈0.05）.Conclusion Distant metastasis associated with portal vein tumor thrombosis are the independent influenced factors on prognosis in patients with advanced hepatocellular carcinoma.