肝细胞癌术后复发患者行TACE治疗疗效及影响因素分析

Curative effect of TACE in patients with recurrence after operation for HCC and influence factors analysis

目的探究肝细胞癌(HCC)术后复发患者行经肝动脉介入化疗栓塞术(TACE)治疗疗效及术后复发的影响因素。方法回顾性分析120例HCC术后复发患者的临床资料,依据术后是否接受TACE治疗分为TACE组(n=68)和非TACE组(n=52),统计两组随访生存率,分析患者TACE预后影响因素。结果TACE组1、2年总体生存率分别为88.2%、80.9%,与非TACE组的86.5%、76.9%比较,差异无统计学意义(P>0.05),TACE组术后3年总体生存率67.65%较非TACE组的48.08%高(P<0.05)。血管侵犯(OR=1.102,P=0.013,95%CI:1.016~1.382)、最大癌结节直径>5 cm(OR=1.433,P=0.005,95%CI:1.012~2.238)是HCC术后复发患者TACE预后的影响因素(P<0.05)。结论HCC术后复发患者行TACE能有效改善预后,或可推荐血管侵犯、最大癌结节直径>5 cm的术后复发患者行TACE治疗。

Objective To investigate the curative effect of transcatheter arterial chemoembolization(TACE)in patients with recurrence after operation for hepatocellular carcinoma(HCC)and the influence factors.Methods The clinical data of 120 patients with recurrence after operation for HCC were retrospectively analyzed.According to the implementation of TACE after operation,the patients were divided into TACE group(n=68)and non-TACE group(n=52).The follow-up survival rates of the two groups were statistically analyzed,and influence factors of prognosis after TACE were analyzed.Results There was no significant difference in the 1-year or 2-year overall survival rates between TACE group(88.2%,80.9%)and non-TACE group(86.5%,76.9%)(P>0.05).The postoperative 3-year overall survival rate in TACE group was significantly higher than that in non-TACE group(67.65%vs 48.08%)(P<0.05).Vascular invasion(OR=1.102,P=0.013,95%CI:1.016-1.382)and the maximum diameter of tumor nodules>5 cm(OR=1.433,P=0.005,95%CI:1.012-2.238)were influence factors of the prognosis of TACE after operation for HCC(P<0.05).Conclusion The implementation of TACE in patients with recurrence after operation for HCC can effectively improve the prognosis.For patients with recurrence and vascular invasion and maximum diameter of tumor nodules above 5 cm,TACE is recommended.