PA-TACE的时机选择对肝细胞癌患者根治性切除术后近期预后的影响OACSTPCD
Effect of PA-TACE timing on the short-term prognosis of patients with hepatocellular carcinoma after radical resection
目的 探讨肝癌根治性切除术后辅助性肝动脉化疗栓塞(PA-TACE)治疗的时机选择对肝细胞癌(HCC)患者近期预后的影响.方法 回顾性分析南京医科大学附属无锡人民医院2015年1月至2021年12月收治的103例肝癌根治性切除术后半年内接受TACE治疗的HCC患者的临床资料,根据术后接受TACE治疗的时间不同,分为观察组(n=53)和对照组(n=50).观察组患者在术后4～8周接受TACE治疗,对照组患者在术后9～26周接受TACE治疗.肝癌根治性切除术后随访2年.对两组患者术后2年复发率、2年生存率进行比较,同时比较TACE治疗期间两组患者不良反应的发生率,以及术后2年两组患者在各项评估量表指标上的差异.结果 与对照组相比,观察组患者肝癌根治性切除术后2年复发率较低[20.8%(11/53)vs 48.0%(24/50),χ2=7.429,P=0.006],术后2年生存率较高[88.7%(47/53)vs 78.0%(39/50),χ2=5.316,P=0.021],差异具有统计学意义(P<0.05);TACE治疗期间,两组患者不良反应的总发生率差异无统计学意义(χ2=0.160,P>0.05);肝癌根治性切除术后2年,与对照组相比,观察组患者的PS评分、Child-Pugh评分、PS-SGA评分、FPS-R评分均较低,但差异均无统计学意义(P>0.05);观察组患者生活质量评分较对照组高,差异具有统计学意义(t=7.236,P<0.05).结论 HCC患者在肝癌根治性切除术后4～8周内接受PA-TACE治疗,能减少术后早期肿瘤复发率,提高生存率,提高患者手术后的生活质量.
Objective To investigate the effect of postoperative adjuvant transarterial chemoembolization(PA-TACE)timing on the short-term prognosis of patients with hepatocellular carcinoma(HCC)after radical resection.Methods The clinical data of 103 HCC patients,who received TACE treatment within 6 months after radical resection in the Affiliated Wuxi People's Hospital of Nanjing Medical University from Jan.2015 to Dec.2021,was retrospectively analyzed.Patients were divided into the observaional group(n=53)and the control group(n=50).Patients in the observaional group received TACE treatment 4-8 weeks after HCC radical resection,and patients in the control group received TACE treatment 9-26 weeks after HCC radical resection.All patients were followed-up for 2 years postoperatively.The postoperative 2-year recurrence rate and 2-year survival rate were compared between the two groups.The incidence of adverse reactions during TACE treatment,and the differences in each evaluation scale index between the two groups 2 years postoperatively were compared.Results Compared with the control group,the observaional group had a lower postoperative 2-year recurrence rate[20.8%(11/53)vs 48.0%(24/50),χ2=7.429,P=0.006]and a higher postoperative 2-year survival rate[88.7%(47/53)vs 78.0%(39/50),χ2=5.316,P=0.021]after HCC radical resection,the differences were statistically significant(P<0.05).During TACE treatment,there was no significant difference in the total incidence rate of adverse reactions between the two groups(χ2=0.160,P>0.05).Two years after HCC radical resection,the PS score,Child-Pugh score,PS-SGA score and FPS-R score in the observaional group were all lower than those in the control group,but the differences were not statistically significant(P>0.05).The score of life quality in the observaional group was higher than that in the control group,and the difference was statistically significant(t=7.236,P<0.05).Conclusion PA-TACE within 4 to 8 weeks after HCC radical resection can reduce the early postoperative tumor recurrence rate,improve the survival rate,and improve the life quality of HCC patients.
顾炜;张智勇;吴鸣宇;季圆
南京医科大学附属无锡人民医院/南京医科大学无锡医学中心肝胆外科,江苏 无锡 214023南京医科大学附属无锡人民医院/南京医科大学无锡医学中心健康管理中心,江苏 无锡 214023
临床医学
肝细胞癌根治性切除术术后辅助性肝动脉化疗栓塞治疗时机近期预后
hepatocellular carcinomaradical resectionpostoperative adjuvant transarterial chemoembolizationtreatment timingrecent prognosis
《肝胆胰外科杂志》 2024 (004)
198-204 / 7
2022年度无锡市卫生健康委科研面上项目(M202254).
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