2003~2013年某肿瘤专科医院肝细胞癌肿瘤分期及首次治疗方法调查分析

Tumor stage and primary treatment selection among patients with hepatocellular carcinoma from 2003 to 2013

目的分析广西某三级甲等肿瘤专科医院近10年肝细胞癌(hepatocellular carcinoma,HCC)肿瘤分期和首次治疗方法的构成比。方法回顾性分析该院2003年1月至2013年10月收治首诊的HCC患者资料,参考巴塞罗那临床肝癌分期系统(Barcelona Clinical Liver Cancer,BCLC),分析HCC各分期以及首次治疗方式所占比例。结果共6241例HCC患者纳入分析,其中BCLC-0/A期、B期、C期、D期HCC患者所占比例依次为28.9%、16.2%、53.6%、1.3%。所有患者中,接受肝切除术、介入治疗、放射治疗、消融治疗、全身系统化疗、中医中药治疗、靶向药物治疗和未治疗的患者依次占33.3%、36.7%、2.2%、0.9%、8.8%、4.2%、0.1%、13.8%。在BCLC-O/A期和B期HCC患者中,肝切除术是主要的治疗方式,而在BCLC-C期患者中,主要的治疗方式是介入治疗。结论该院BCLC-B期和C期HCC患者比重大,肝切除术和介入治疗是主要的治疗方式。

Objective This study reviewed the frequencies of each tumor stage and each type of primary treatment modality among patients with primary hepatocellular carcinoma （HCC）treated at a tertiary tumor hospital over the last decade. Methods Baseline data of patients with primary HCC treated between January 2003 and October 2013 were retrospectively collected. Tumor stage was determined according to the Barcelona Clinic Liver Cancer （BCLC） staging system. Results A total of 6,241 patients with primary HCC were included in the analysis,of whom 28.9% were in stage BCLC-0/A; 16.2% , BCLC-B; 53.6% , BCLC-C ; and 1.3% , BCLC-D. Treatment modalities applied to this patient group were as follows ： hepatic resection, 33.3% ; interventional therapy, 36.7% ; radiotherapy, 2.2% ; ablation therapy, 0.9% ; systemic chemotherapy, 8.8 % ; traditional herbal medicine therapy, 4.2 % ; targeted drug therapy, 0.1% ; and no treatment, 13.8%.Hepatic resection was the most frequent therapy for patients with BCLC-0/A/B disease, and interventional treatment was the first-line therapy for patients with BCLC-C disease. Conclusion Prevalence of stage BCLC-B and-Cdisease was high among our HCC patients.Hepatic resection and interventional treatment are first-line therapies for both stages.