TACE序贯联合PMCT治疗原发性肝癌的预后因素分析

倪嘉延; 许林锋; 陈耀庭; 孙宏亮; 谭绮尹; 胡仁美

doi:10.3969/j.issn.1000-8179.2013.01.011

TACE序贯联合PMCT治疗原发性肝癌的预后因素分析

doi: 10.3969/j.issn.1000-8179.2013.01.011

中山大学孙逸仙纪念医院介入放射科（广州市510120）

详细信息

通讯作者:
许林锋 xulf1@21cn.com

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出版历程
- 收稿日期: 2012-08-20
- 修回日期: 2012-10-25

Prognostic factors affecting transarterial chemoembolization sequentially combined with percutaneous microwave coagulation therapy in treatment of hepatocellular carcinoma

Department of Interventional Radiology, Sun Yat-sen University, Sun Yat-sen Memorial Hospital, Guangzhou 510120, China

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Corresponding author: Linfeng XU; E-mail: xulf1@21cn.com

摘要

摘要: 目的分析影响动脉化疗栓塞术(transarterial chemoemlolization, TACE)序贯联合微波凝固消融(percutaneous micro wave coagulation therapy, PMCT)治疗原发性肝癌预后的主要因素。方法本研究收集本科收治的97例接受TACE序贯联合PMCT治疗的原发性肝癌患者。对可能影响预后的各变量进行单因素分析, 再利用多因素Cox逐步回归分析影响预后的主要因素。结果本组肝癌患者的1、2、3、5年累积生存率分别为68.2%、43.2%、28.8%、13.4%。单因素分析与预后有关的因素为肿瘤大小、临床分期(BCLC)、Child-Pugh分级、门脉癌栓、动静脉瘘、PMCT治疗次数及体力状况(ECOG评分)。Cox逐步回归多因素分析与预后有关并具有显著意义的因素为肿瘤大小、临床分期、门脉癌栓、PMCT治疗次数及体力状况。结论适当重复PMCT治疗可以延长肝癌患者的生存期限。大肝癌、门脉癌栓为预后的危险性因素, 巨块型肝癌及伴门脉主干癌栓患者的中位生存时间明显缩短。
- 原发性肝癌 /
- 动脉化疗栓塞 /
- 微波凝固消融 /
- 预后 /
- 回归分析
Abstract: Objective This study aims to investigate the main prognostic factors affecting sequential transarterial chemoembolization(TACE) with percutaneous microwave coagulation therapy(PMCT).Methods: A total of 97 hepatocellular carcinoma cases treated by sequential TACE combined with PMCT at Sun Yat-sen Memorial Hospital from January 2005 to December 2010 were selected.Univariate analysis was conducted followed by multivariate Cox regression analysis to determine the prognostic factors. Methods A total of 97 hepatocellular carcinoma cases treated by sequential TACE combined with PMCT at Sun Yat-sen Memorial Hospital from January 2005 to December 2010 were selected.Univariate analysis was conducted followed by multivariate Cox regression analysis to determine the prognostic factors. Results The 1-, 2-, 3-, and 5-year patient survival rates were 68.2%, 43.2%, 28.8%, and 13.4%, respectively.Univariate analysis identified the following as factors: tumor size, the Barcelona Clinic Liver Cancer(BCLC) staging, liver function grading by the Child-Pugh score, portal vein tumor thrombus, arteriovenous fistula, frequency of PMCT, and physical strength by the Eastern Cooperative Oncology Group(ECOG) standards.Prognostic factors determined by multivariate analysis using Cox stepwise regression included tumor size, BCLG staging, portal vein tumor thrombus, frequency of PMCT, and physical strength by the ECOG standards. Conclusion Retreatment with PMCT under suitable physical conditions and liver function can prolong the survival time of liver cancer patients.Large hepatocellular carcinoma and portal vein cancerous thrombus are the risk factors affecting the prognosis.The median survival time of the patients with massive liver tumor or portal vein tumor thrombus is markedly reduced.
- hepatocellular carcinoma /
- transarterial chemoembolization /
- percutaneous microwave coagulation therapy /
- prognosis /
- regression analysis

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图 1 97例肝癌患者的Kaplan-Meier生存曲线

Figure 1. Kaplan-Meier survival curve for the 97 patients

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表 1 纳入研究病例基本特征及结果

Table 1. Baseline and case study results

表 2 Cox逐步回归分析结果

Table 2. Results of multivariate analysis using stepwise Cox regression

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