中国癌症防治杂志2025，Vol.17Issue(3)：281-288,8.DOI:10.3969/j.issn.1674-5671.2025.03.04
合并微血管侵犯的中晚期肝细胞癌根治性切除术后经导管动脉化疗栓塞术的疗效分析:一项多中心队列研究
Efficacy of transcatheter arterial chemoembolization following radical resection in cases of intermediate to advanced hepatocellular carcinoma with microvascular invasion:A mul-ticenter cohort study
摘要
Abstract
Objective To evaluate the efficacy of transcatheter arterial chemoembolization(TACE)for intermediate to advanced hepato-cellular carcinoma(HCC)patients with microvascular invasion(MVI)after radical resection.Methods A retrospective analysis was conducted on patients with intermediate to advanced HCC,who were postoperatively diagnosed with revealed MVI through pathological examination,across at five hospitals from January 14,2019 to June 20,2024.The study compared recurrence-free survival(RFS),overall survival(OS),and safety between patients who received postoperative TACE and underwent active surveillance.Results In a cohort of 335 included patients,148 received postoperative TACE and 187 underwent active surveillance.During follow-up period,the postoperative TACE group demonstrated a significantly longer median RFS compared to the active surveillance group(15.2 months vs 12.0 months;HR=0.69,95％CI:0.54-0.88,P=0.003).Although the median OS was not reached in the postoperative TACE group,there was a trend toward improved OS relative to the active surveillance group(not reached vs 33.1 months;HR=0.55,95％CI:0.40-0.77,P=0.001).Following propensity score matching,the postoperative TACE group demonstrated significantly superior RFS and OS compared to the active surveillance group(all P＜0.05).Subgroup analysis based on tumor staging revealed comparable outcomes for patients with intermediate stage HCC in both groups,but significantly improved RFS and OS with advanced stage HCC patients in the postoperative TACE group(all P＜0.05).Adverse events associated with postoperative TACE were primarily transient liver injury and nausea/vomiting,with no grade 4 or 5 events reported.Conclusions TACE following radical resection could improve the RFS and OS in some patients with intermediate to advanced HCC exhibiting MVI,particularly in those at advanced stages.However,further prospective randomized trials are crucial to validate these findings.关键词
肝细胞癌/根治性切除术/经导管动脉化疗栓塞术/微血管侵犯Key words
Hepatocellular carcinoma/Radical resection/Transcatheter arterial chemoembolization/Microvascular invasion分类
医药卫生引用本文复制引用
李文阳,黎乐群,钟鉴宏,苏家勇,刘绍平,刘振,彭宁,罗敏,范缘,林雷珀,马良..合并微血管侵犯的中晚期肝细胞癌根治性切除术后经导管动脉化疗栓塞术的疗效分析:一项多中心队列研究[J].中国癌症防治杂志,2025,17(3):281-288,8.基金项目
国家自然科学基金项目(82260569) （82260569）
广西重点研发计划项目(桂科AB25069099 （）
桂科AB24010082) （）
广西高校人体发育与疾病研究重点实验室开放课题(广西医科大学)(RTFY202501) （广西医科大学）
