Hepatitis status, Child-Pugh classification, and serum AFP levels predict survival in patients treated with transarterial embolization for unresectable hepatocellular carcinoma
Hepatitis status, Child-Pugh classification, and serum AFP levels predict survival in patients treated with transarterial embolization for unresectable hepatocellular carcinoma
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DOI：
10.1016/j.gassur.2004.11.002
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发表时间：
2005-05-01
影响因子：
3.2
通讯作者：
Harrison, LE
中科院分区：
文献类型：
--
作者：
Reichman, TCW;Bahyramipour, P;Harrison, LE
肝细胞癌（HCC）是世界范围内最常见的癌症之一。大多数患者不适合手术，经动脉栓塞（TAE）已用于治疗不可切除的HCC患者。本研究的目的是确定在西方医学中心接受TAE治疗的患者的生存预测因素。回顾前瞻性数据库，确定了1998年7月至2004年7月期间在大学医院（纽瓦克，NJ）接受HCC治疗的345例患者。在这些患者中，109例患者接受了TAE。其中11例患者随后接受手术治疗，并从本研究中排除。在其余98例患者中，通过单变量和多变量分析来分析人口统计学数据和实验室值以预测生存率。单因素分析显示，包括肝炎状态、Child-Pugh分级、血清甲胎蛋白水平< 500 ng/ml、胆红素< 2.6 mg/dl、凝血酶原时间< 16秒、血小板计数< 200 x 10（9）/l、白蛋白> 3.5 gm/dl和多种治疗在内的多个因素可预测生存率。多变量分析发现血清甲胎蛋白水平、Child-Pugh分级和肝炎状态是独立预测生存率的因素。这些因素可能有助于选择可能受益于TAE的不可切除HCC患者。(c)2005年，消化道外科学会。
Hepatocellular carcinoma (HCC) represents one of the most prevalent cancers worldwide. Most patients are not surgical candidates, and transarterial embolization (TAE) has been used to treat patients with unresectable HCC. The purpose of this study was to identify factors that predict survival in patients treated with TAE at a Western medical center. Review of a prospective database identified 345 patients treated for HCC at University Hospital (Newark, NJ) between July 1998 and July 2004. Of these patients, 109 patients underwent TAE. Eleven of these patients were subsequently treated surgical, and excluded from this study. Of the remaining 98 patients, demographic data and laboratory values were analyzed to predict survival by univariate and multivariate analysis. Several factors, including hepatitis status, Child-Pugh classification, serum alpha fetoprotein levels < 500 ng/ml, bilrubin < 2.6 mg/dl, prothrombin time < 16 seconds, platelet count < 200 x 10(9)/l, albumin > 3.5 gm/dl, and multiple treatments, predicted survival by univariate analysis. Serum alpha fetoprotein levels, Child-Pugh classification, and hepatitis status were found by multivariate analysis to independently predict survival. These factors may help to select patients with unresectable HCC who might benefit from TAE. (c) 2005 The Society for Surgery of the Alimentan Tract.