辅助性经动脉化疗栓塞治疗合并微血管侵犯的肝细胞癌患者。
Adjuvant transarterial chemoembolization for patients with hepatocellular carcinoma involving microvascular invasion.
机构信息
Department of Hepatobiliary Surgery, Affiliated Tumor Hospital of Guangxi Medical University, Nanning, 530021, China; Key Laboratory for High-Incidence Tumor Prevention and Treatment, Ministry of Education, China.
Department of Hepatobiliary Surgery, Affiliated Tumor Hospital of Guangxi Medical University, Nanning, 530021, China; Key Laboratory for High-Incidence Tumor Prevention and Treatment, Ministry of Education, China; Guangxi Liver Cancer Diagnosis and Treatment Engineering and Technology Research Center, Nanning, 530021, China.
出版信息
Am J Surg. 2019 Apr;217(4):739-744. doi: 10.1016/j.amjsurg.2018.07.054. Epub 2018 Aug 6.
BACKGROUND
Microvascular invasion (MVI) has recently been reported to be an independent prognostic factor in patients with hepatocellular carcinoma (HCC). This study compared the outcomes of adjuvant transarterial chemoembolization (A-TACE) after hepatic resection (HR) in patients with HCC involving MVI.
METHODS
This prospective study involved 200 consecutive patients with MVI-HCC who underwent HR alone (n = 109) or HR with A-TACE (n = 91).The Kaplan-Meier method was used to compare disease-free survival (DFS) and overall survival (OS).
RESULTS
The two groups showed similar DFS at 1, 2, and 3 years (P = 0.077). The A-TACE group showed significantly higher OS than the HR-only group (P = 0.030). Subgroup analysis showed that A-TACE was associated with significantly higher DFS and OS among patients with a tumor diameter >5 cm or with multinodular tumors.
CONCLUSIONS
A-TACE may improve postoperative outcomes for MVI-HCC patients, especially those with tumor diameter >5 cm or multinodular tumors.
背景
微血管侵犯（MVI）最近被报道为肝细胞癌（HCC）患者的独立预后因素。本研究比较了伴有 MVI 的 HCC 患者肝切除术后（HR）辅助经动脉化疗栓塞（A-TACE）的结局。
方法
这项前瞻性研究纳入了 200 例接受 HR 治疗（n=109）或 HR 联合 A-TACE 治疗（n=91）的 MVI-HCC 连续患者。采用 Kaplan-Meier 法比较无病生存率（DFS）和总生存率（OS）。
结果
两组患者 1、2、3 年 DFS 相似（P=0.077）。A-TACE 组的 OS 明显高于 HR 组（P=0.030）。亚组分析显示，A-TACE 与肿瘤直径>5cm 或多结节肿瘤患者的 DFS 和 OS 显著相关。
结论
A-TACE 可能改善 MVI-HCC 患者的术后结局，尤其是肿瘤直径>5cm 或多结节肿瘤患者。
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