肝胆胰外科杂志2025，Vol.37Issue(12)：802-808,813,8.DOI:10.11952/j.issn.1007-1954.2025.12.003
TACE联合索拉非尼治疗肝细胞癌根治术后微血管侵犯的临床效果
Efficacy of transarterial chemoembolization combined with sorafenib on microvascular invasion in hepatocellular carcinoma patients after radical resection
摘要
Abstract
Objective To investigate the efficacy of postoperative adjuvant transarterial chemoembolization(TACE)combined with sorafenib in patients with microvascular invasion(MVI)-positive hepatocellular carcinoma(HCC)after radical resection.Methods Clinical data of 100 patients with MVI-positive HCC who underwent radical resection at Handan First Hospital from January 2019 to June 2023 were retrospectively analyzed.Based on postoperative adjuvant therapy,patients were divided into the TACE plus sorafenib group(T+S group,n=50)and the TACE alone group(T group,n=50).Recurrence-free survival(RFS)and overall survival(OS)were compared between the two groups,including the 1-and 2-year RFS rates and the 2-and 3-year OS rates.The Cox proportional hazards model was used to identify risk factors for RFS and OS.Results Compared with the T group,the T+S group had significantly longer median RFS(23.3 months vs 12.0 months,HR=2.346,95％CI 1.366 to 4.029,P=0.001)and median OS(37.1 months vs 23.1 months,HR=2.115,95％CI 1.149 to 3.891,P=0.014).The 1-year and 2-year RFS rates in the T+S group were significantly higher than those in the T group(79.9％vs 51.1％,46.0％vs 23.7％,both P<0.05).The 2-year and 3-year OS rates in the T+S group were also significantly higher(75.4％vs 48.6％,51.4％vs 23.9％,both P<0.05).Multivariate Cox regression analysis identified maximum tumor diameter≥5 cm and M2-grade MVI as independent risk factors for RFS(P<0.05),and M2-grade MVI as an independent risk factor for OS(P<0.05).No intolerable adverse reactions,unexpected adverse events,or treatment-related deaths occurred in either group.Conclusion For patients with MVI-positive HCC after radical resection,adjuvant TACE combined with sorafenib can reduce the risk of early recurrence and improve prognosis compared with TACE alone,with a good safety profile.Maximum tumor diameter≥5 cm and M2-grade MVI are independent risk factors for RFS,and M2-grade MVI is an independent risk factor for OS.关键词
肝细胞癌/根治性切除/微血管侵犯/经导管动脉化疗栓塞/索拉非尼/肿瘤早期复发Key words
hepatocellular carcinoma/radical resection/microvascular invasion/transarterial chemoembolization/sorafenib/early tumor recurrence分类
医药卫生引用本文复制引用
ZHANG Peng,LI Xiaoli,MA Guanghui..TACE联合索拉非尼治疗肝细胞癌根治术后微血管侵犯的临床效果[J].肝胆胰外科杂志,2025,37(12):802-808,813,8.基金项目
河北省邯郸市科学技术研究与发展项目(23422083260). （23422083260）
