辅助性肝动脉栓塞对原发性肝癌切除术后患者预后影响分析

Influence of adjuvant TACE prognosis for patients with primary liver cancer

目的探讨辅助性肝动脉化疗栓塞（transcatheter arterial chemoembolization,TACE）对原发性肝癌切除术后患者预后影响,为临床诊治提供参考。方法选择2011年1月～2012年1月60例原发性肝癌患者,按照治疗方法分为对照组与观察组。对照组单纯行原发性肝癌切除术,观察组患者在原发性肝癌切除术基础上行辅助性TACE治疗;分析原发性肝癌术后复发危险因素,对比两组3年生存率及无瘤生存率。结果肿瘤直径、肿瘤数目、术前AFP、血管癌栓均是独立危险因素（P〈0.05）;肿瘤直径≥5 cm的高危患者行TACE术后1年无瘤生存率72.73%,3年无瘤生存率36.36%,明显高于未行TACE术的高危患者,差异有统计学意义（P〈0.05）;肿瘤直径≥5 cm的高危患者行TACE术后1年生存率81.82%,3年生存率45.45%,明显高于未行TACE术的高危患者,差异有统计学意义（P〈0.05）。结论术后辅助性TACE有利于延缓肝内复发或降低复发率,且对高危险因素患者生存延长效果更显著。

Objective To investigate influence of adjuvant TACE prognosis for patients with primary liver cancer, to provide a reference for clinical treatment. Methods From January 2011 to January 2012, 60 cases with primary liver cancer patients were selected, they were divided into observation group and the control group according to treatment methods, the control group was treated with primary liver cancer resection, observation group excepted liver cancer surgery was also implemented with TACE treatment, primary liver cancer recurrence risk factors were analyzed, 3-year survival and disease-free survival rate were compared. Results Tumor size, tumor number, preoperative AFP, vascular thrombosis were independent risk factors（P〈0.05）; tumor diameter ≥5 cm high-risk patients after with TACE 1-year survival rate was 72.73%, 3-year survival rate was 36.36%, significantly higher than the non-TACE patients（P〈0.05）;tumor diameter≥5 cm high-risk patients after with TACE 1-year survival rate was 81.82%, 3-year survival rate was45.45%, significantly higher than the non-TACE patients（P〈0.05）. Conclusion Prophylactic TACE can help to delay or reduce the recurrence rate for patients with primary liver cancer, especially patients with risk factors.