肝癌合并门脉癌栓术后行肝动脉栓塞化疗联合门静脉化疗的临床疗效分析

Analysis of the Clinical Curative Effect of Hepatic Artery Embolism Chemotherapy Combined with Portal Vein Chemotherapy on Patients after the Surgery of Hepatic Carcinoma with Portal Vein Tumor Emboli

目的探讨预防肝癌合并门静脉癌栓术后复发、提高生存的有效措施。方法选取手术切除的肝癌合并门静脉癌栓患者作为研究对象,随机分为4组:A组仅行手术切除;B组行手术+肝动脉栓塞化疗;C组为手术+门静脉化疗;D组行手术+序贯联合肝动脉栓塞化疗和门静脉化疗。比较四组患者1、2、3年的总生存率。结果各组患者0.5、1、2、3年的总生存率分别为A组44.4%、27.8%、11.1%、5.0%;B组56.0%、44.0%、28.0%、20.0%;C组54.5%、40.9%、27.3%、18.2%;D组69.2%、53.8%、42.3%、30.7%,D组患者的总生存率明显高于其他几组患者(P<0.05),B组和C组的生存率比较差异无统计学意义(P>0.05),而A组的生存率均明显低于其他几组(P<0.05)。结论术后肝动脉栓塞化疗和门静脉化疗是减少肝癌合并门脉癌栓患者术后复发有效方法。两者的联合应用对进一步减少肝癌合并门脉癌栓患者术后复发、提高生存率有较大的临床意义。

Objective To explore the effective measures for the prevention of recurrence and improve the survival of the patients after the surgery of hepatic carcinoma with portal vein tumor emboli. Methods The patients underwent the surgery of resection of hepatocellular carcinoma with portal vein tumor emboli were selected as the subjects and randomly divided into 4 groups： group A only received the operation for excision, group B underwent the operation and hepatic artery chemoembolization; group C received the operation and portal vein chemotherapy; group D underwent the operation and sequential combination of hepatic artery chemoembolization and portal vein chemotherapy. And the overall 1, 2, 3 years of survival rate was compared between the four groups. Results The overall 0.5, 1, 2, 3 years of survival rate of group A was 44.4%, 27.8%, 11.1%, 5.0%, respectively; and that of group B was 56.0%, 44.0%, 28.0%, 20.0%, respectively; that of group C was 54.5%, 40.9%, 27.3%, 18.2%, respectively; that of group D was 69.2%, 53.8%, 42.3%, 30.7%, respectively. The overall survival rates of group D were significantly higher than those of the other groups（P〈0.05）, the differences in survival rates between group B and group C were not statistically significant（P〉0.05）, while the survival rates of group A were significantly lower than those of the other groups（P〈0.05）. Conclusion Postoperative hepatic artery chemoembolization and portal vein chemotherapy are effective methods for reducing the postoperative recurrence of patients with hepatic carcinoma and portal vein tumor emboli, and the application of combination of them is of great clinical sig-nificance in further reducing the postoperative recurrence and improving the survival rate of the patients.