Preoperative Transarterial Chemoembolization for Hepatocellular Carcinoma
Preoperative Transarterial Chemoembolization for Hepatocellular Carcinoma
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DOI：
10.5754/hge10730
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发表时间：
2012-10-01
影响因子：
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通讯作者：
Yamaguchi, Toshiharu
中科院分区：
文献类型：
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作者：
Kishi, Yoji;Saiura, Akio;Yamaguchi, Toshiharu
背景/目标：肝细胞癌（HCC）切除术前经动脉化疗栓塞（TACE）的效果存在争议。方法学：比较术前TACE后行肝切除术（A组，69例患者）或仅行切除术（B组，158例患者）的临床病理特征和预后。单因素和多因素分析用于评价TACE是否影响患者预后。结果如下：A组与B组相比，年龄小、肝切除率高、切缘阳性率高、血管侵犯和低分化肝癌发生率高。A组的总生存率明显差于B组（5年生存率; 29% vs. 69%; p1 L（HR=1.8; 95%CI =1.1-2.8）和血管浸润（HR=2.3; 95%CI =1.43.6）是生存不良的独立预测因素。术前TACE也是肝外转移的独立预测因子（比值比，2.8; 95% CI=1.1-7.1）。结论：术前TACE不应常规应用于HCC。
Background/Aims: The effects of transarterial chemoembolization (TACE) prior to hepatectomy for patients with hepatocellular carcinoma (HCC) are controversial. Methodology: Clinicopathological profiles and prognosis were compared between patients who underwent hepatic resection following preoperative TACE (Group A, 69 patients) or only resection (Group B, 158 patients). Univariate and multivariate analyses were used to evaluate whether TACE influenced patient prognosis. Results: Profiles of Group A were comparable with those of Group B except for younger age, higher frequency of major hepatectomy, higher incidence of positive surgical margin, vascular invasion and poorly differentiated HCC. Overall survival was significantly worse in Group A than in Group B (5-year survival rate; 29% vs. 69%; p1L (HR=1.8; 95% CI=1.1-2.8) and vascular invasion (HR=2.3; 95% CI=1.43.6) were independent predictors of poor survival. Preoperative TACE was also an independent predictor of extrahepatic metastases (odds ratio, 2.8; 95% CI=1.1-7.1). Conclusions: Preoperative TACE should not be routinely applied for HCC.