张成 1祁兴顺 1柏明 1赵艳 1王维娟 1韩国宏1
作者信息
- 1. 第四军医大学西京医院 消化七科，国家肿瘤生物学重点实验室，西安710032
- 折叠
摘要
Abstract
Objective Toinvestigatethetherapeuticeffectoftranscatheterarterialchemoembolization(TACE)inpatientswithhepatocellu-larcarcinoma(HCC)complicatedbyportalveintumorthrombus,andtoidentifyrelatedprognosticfactors.Methods Theclinicaldataof 152 HCC patients with portal vein tumor thrombus who were admitted to Xijing Hospital of Fourth Military Medical University and received TACE from January 2006 to December 2010 were analyzed retrospectively.The occurrence of post-TACE liver failure,upper gastrointesti-nal bleeding,and post-embolization syndrome was observed,and survival data and prognostic factors were analyzed.The Kaplan-Meier method was used to calculate cumulative survival rate,the log-rank test was used for univariate analysis,and the Cox proportional hazards modelwasusedformultivariateanalysis.Results Themediansurvivaltimewas5.0months,andthe6-,12-,and18-monthcumula-tive survival rates were 37%,18%,and 9%,respectively.Univariate analysis showed that tumor size,tumor type,involvement of both liv-er lobes,distant metastasis,and Child-Pugh class were the prognostic factors for TACE in HCC patients with portal vein tumor thrombus (χ2 =5.108,11.542,6.036,12.319,and 22.574,respectively,all P<0.05);multivariate analysis showed that tumor size,tumor type,distant metastasis,and Child -Pugh class were the independent prognostic factors (Wald values =11.243,5.021,7.651,and 25.876,respectively,all P<0.05);Child-Pugh class was the only influencing factor for liver failure in HCC patients with portal vein tumorthrombus(P=0.015).Conclusion TACEissafeandeffectiveinHCCpatientswithportalveinthrombusandgoodliverfunction. Tumor size,tumor type,distant metastasis,and Child-Pugh class are the main factors influencing survival,which provides a basis for clini-cians to select appropriate interventional therapies.关键词
癌,肝细胞/门静脉/化学栓塞,治疗性/预后/危险因素Key words
carcinoma,hepatocellular/portal vein/chemoembolization,therapeutic/prognosis/risk factors分类
医药卫生
