Hepatic resection after transarterial chemoembolization increases overall survival in large/multifocal hepatocellular carcinoma: a retrospective cohort study
Hepatic resection after transarterial chemoembolization increases overall survival in large/multifocal hepatocellular carcinoma: a retrospective cohort study
复制标题
经动脉化疗栓塞术后肝切除可提高大/多灶性肝细胞癌的总生存率：一项回顾性队列研究
DOI：
10.18632/oncotarget.13427
复制
发表时间：
2017-01-03
期刊：
影响因子：
--
通讯作者：
Huang, Mingsheng
中科院分区：
文献类型：
--
作者：
Chen, Junwei;Lai, Lisha;Huang, Mingsheng
为探讨肝动脉化疗栓塞术(TACE)后肝切除(HR)的预后，回顾分析了2006年1月至2010年12月连续行肝动脉化疗栓塞术(TACE)的大/多灶性肝细胞癌患者的临床资料。单独接受TACE的患者包括T组(61名患者)，而接受TACE后接受HR的患者包括T+R组(49名患者)。所有手术均顺利完成，仅发生一例V类并发症。肝功能在HR后1周内恢复，1个月内恢复。比较T+R组和T组的总生存期，并根据基线甲胎蛋白水平、甲胎蛋白降低和HR前肿瘤反应进行亚组分析。T+R组总生存期(OS)明显长于T组(47.00vs.20.001.85月，P<；0.001)。AFP降低的T+R组的OS低于50%，HR前肿瘤反应差的患者OS与T组无差异(P&gT；0.05)。这些患者可能不会从联合治疗中受益。我们的研究结果表明，与单纯TACE相比，TACE后的HR对大/多灶性肝癌是安全有效的，并且延长了OS。
To investigate the prognosis of transarterial chemoembolization (TACE) followed by hepatic resection (HR) in large/multifocal hepatocellular carcinoma (HCC), the medical records of consecutive HCC patients who underwent TACE between January 2006 and December 2010 were retrospectively analyzed. Patients who received TACE alone comprised the T group (61 patients), while those who received HR after TACE comprised the T+R group (49 patients). All the resections were successfully performed, and only one class V complication occurred. While liver function was altered from baseline within 1 week after HR, it recovered within 1 month. Overall survival (OS) of the T+R and T groups were compared, and sub-group analyses were performed based on baseline α-fetoprotein (AFP) levels, the reduction of AFP, and tumor response before HR. Overall survival (OS) in the T+R group was longer than in the T group (47.00 ± 2.87 vs. 20.00 ± 1.85 months, P < 0.001). OS in the T+R group with AFP reduction was less than 50%, and OS among those with a poor tumor response before HR did not differ from the T group (P > 0.05). These patients may not benefit from the combined treatment. Our findings suggest HR after TACE is safe and effective for large/multifocal HCC, and prolongs OS when compared to TACE alone.