术前经导管动脉栓塞化疗对孤立性大肝癌病人术后生存的影响

Impact of preoperative transcatheter arterial chemoembolization on the survival of patients with solitary large liver cancer

目的探讨术前行经导管动脉栓塞化疗(transcatheter arterial chemoembolization, TACE)对孤立性大肝癌病人的有效性及安全性。方法选取内江市第二人民医院2014年2月至2017年3月经术前影像学及多学科诊断为可切除的孤立性大肝癌病人92例,按治疗方式分为TACE-手术组(42例)和手术组(50例),TACE-手术组病人先行TACE治疗后再行手术切除。分析两组间的并发症及生存差异。结果 TACE-手术组1、3、5年生存率和中位生存期分别为85.2%、43.7%、29.6%和35.5个月,手术组分别为75.5%、31.1%、18.7%和23.5个月,TACE-手术组1、3、5年无复发生存率和中位无复发生存期分别为58.5%、29.1%、10.6%和13.5个月,手术组分别为41.2%、17.4%、6.5%和6.7个月,两组中位生存期和中位无复发生存期差异均有统计学意义(P<0.05)。两组术后死亡率及并发症发生率差异无统计学意义(P>0.05)。结论孤立性大肝癌病人术前行TACE安全有效,明显增加了病人的长期生存获益。

Objective To explore the effectiveness and safety of preoperative transcatheter arterial chemoembolization(TACE)in patients with solitary large liver cancer.Methods Ninety-two patients with resectable solitary large hepatocellular carcinoma were selected from February 2014 to March 2017.The diagnosis was made by preoperative imaging and multidisciplinary consultations.They were divided into two groups of TACE-surgery(n=42)and surgery(n=50).The complications and survival differences were analyzed between two groups.Results The 1/3/5-year survival rate and median survival of TACE-surgery and surgical groups were 85.2%,43.7%,29.6%,35.5 months and 75.5%,31.1%,18.7%,23.5 months respectively,the 1/3/5-year recurrence-free survival rate and median recurrence-free survival were 58.5%,29.1%,10.6%,13.5 months and 41.2%,17.4%,6.5%,6.7 months respectively.There was significant difference in median overall survival and median recurrence-free survival between the two groups(P<0.05).And no significant inter-group difference existed in postoperative mortality or complication rate(P>0.05).Conclusion For patients with solitary large liver cancer,preoperative TACE is both safe and effective.And it may significantly boost the long-term survival benefit of patients.