经肝动脉化疗栓塞术与肝切除术治疗巴塞罗那B期多发性肝细胞癌的近远期效果比较

黎昕

doi:10.3969/j.issn.1001-5256.2017.07.018

经肝动脉化疗栓塞术与肝切除术治疗巴塞罗那B期多发性肝细胞癌的近远期效果比较

DOI: 10.3969/j.issn.1001-5256.2017.07.018

黎昕

华中科技大学同济医学院附属武汉市中心医院肝胆胰外科

详细信息

中图分类号: R735.7
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出版历程
- 收稿日期: 2016-12-16
- 出版日期: 2017-07-20

Short-and long-term efficacy of transarterial chemoembolization versus liver resection in treatment of patients with Barcelona stage B multiple hepatocellular carcinoma

Li Xin

Department of Hepatobiliary and Pancreatic Surgery, Wuhan Central Hospital, Tongji Medical College, Huazhong University of Science and Technology

摘要

摘要: 目的对比研究经肝动脉化疗栓塞术（TACE）与肝切除术治疗巴塞罗那临床肝癌（BCLC）分期B期的多发性肝细胞癌（HCC）的近远期疗效。方法回顾性分析2010年6月-2011年6月在武汉市中心医院接受治疗的80例BCLC B期多发性HCC患者的临床资料,其中,49例行肝切除术（LR组）,31例行TACE（TACE组）。比较2组患者术后并发症、肝功能变化、生存时间及生存率。计量资料2组间比较采用t检验;计数资料2组间比较采用χ2检验。采用Kaplan-Meier曲线进行生存分析,进一步比较采用log-rank检验。结果术后1周,LR组和TACE组的TBil、ALT、AST均较术前显著升高（LR组:t值分别为3.181、2.181、2.955,P值分别为0.002、0.032、0.004;TACE组:t值分别为3.109、3.965、4.519,P值分别为0.003、<0.001、<0.001）,且术后LR组的AST及ALT显著低于TACE组（t值分别为2.094、2.111,P值分别为0.040、0.038）。LR组的1、3、5年生存率分别为75.51%、5...
- 癌,肝细胞 /
- 化学栓塞,治疗性 /
- 肝切除术 /
- 治疗结果
Abstract: Objective To investigate the short-and long-term efficacy of transarterial chemoembolization (TACE) versus liver resection in the treatment of patients with Barcelona Clinic Liver Cancer (BCLC) stage B multiple hepatocellular carcinoma (HCC) .Methods A retrospective analysis was performed for the clinical data of 80 patients with BCLC stage B multiple HCC who were treated from June 2010 to June 2011, and among these patients, 49 underwent liver resection (LR group) and 31 underwent TACE (TACE group) .The postoperative complications, changes in liver function parameters, survival time, and 1-, 3-, and 5-year survival rates were compared between the two groups.The t-test was used for comparison of continuous data between groups, and the chi-square test was used for comparison of categorical data between groups.The Kaplan-Meier curve was used for survival analysis, The log-rank test was used for conparison between two groups.Results At 1 week after surgery, the LR group and the TACE group had significant increases in total bilirubin, alanine aminotransferase (ALT) , and aspartate aminotransferase (AST) (LR group:t=3.181, 2.181, and 2.955, P=0.002, 0.032, and 0.004;TACE group:t=3.109, 3.965, and 4.519, P=0.003, P<0.001, and P<0.001) , and after surgery, the LR group had significantly lower levels of AST and ALT than the TACE group (t=2.094 and 2.111, P=0.040 and 0.038) .Compared with the TACE group, the LR group had significantly higher 1-, 3-, and 5-year survival rates (75.51%/51.02%/40.82% vs 61.29%/22.58%/9.68%, all P<0.05) and significantly longer median survival time (36.3 months vs 26.5 months, P<0.05) .The LR group had a significantly lower recurrence rate than the TACE group (30.61% vs 67.74%, χ2=10.576, P=0.001) .Conclusion Liver resection has a better effect in the treatment of patients with BCLC stage B multiple HCC than TACE and can improve overall survival and prolong survival time.
- carcinoma, hepatocellular /
- chemoembolization, therapeutic /
- hepatectomy /
- treatment outcome

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