原发性肝癌术后肝动脉栓塞化疗对防治复发的临床价值_0.docVIP

原发性肝癌术后肝动脉栓塞化疗对防治复发的临床价值 【摘要】 目的 探讨术后经胆管肝动脉栓塞化疗（TACE）对肝癌切除术后防治复发的作用。 方法 2000年1月～2003年1月间天津医科大学肿瘤 医院 肝胆外科对561例原发性肝癌患者行手术切除 治疗 ，其中113例患者为观察组（A组），术后接受了TACE防治复发，每3周1次，共行4次；其余448例未行TACE治疗者作为对照组（B组）。结果 A、B两组在性别、年龄、Child-pugh分级、术中失血量及其他临床病 理学 特征差异均无显著性。A、B两组的1年无瘤生存率分别为81.8％和80.9％，无明显差别；2年无瘤生存率为73.5％和67.8％，A组虽较B组高但无统计学意义（P＞0.05）；3年无瘤生存率为65.5％和49.2％，相比较具明显统计学差异（P0.05）。结论 术后 规律 行TACE可以增加肝癌患者术后的无瘤生存率。 【关键词】 肝细胞肝癌；肝动脉栓塞化疗；复发 【Abstract】 Objective We retrospective investigated the effect of postoperative transcatheter arterial chemoembolization (TACE) for prevention recurrence on hepatocellular carcinoma(HCC) after curative liver resection.Methods 561 curative liver resections for HCC were retrospectively reviewed in the department of hepatobiliary surgery， Tianjin Medical Cancer Hospital between Jan 2000 and Jan 2003. All the 561 patients were divided into 2 groups. Transcatheter arterial chemoembolization(TACE) had been performed postoperatively in 113 patients(group A)； the other 448 patients recEived hepatectomy only(group B).Two group patients were followed up closely on Bus，CT，AFP and so on.Results The re was no significant differences in the parameters of clinicopathological findings and surgical outcomes， including gender，age，operating time， Child-Pugh classification， blood loss，and mortality，et al.In contrast，the disease free survival rate in group A and B were respectively 81.8% vs.80.9% at 1 year， 73.5％ vs 67.8％ at 2 year，65.5% vs.49.2% at 3 years.There was no special difference between group A and B at 1 or 2 year，but there was significant difference at 3 year between them.Conclusion There was significant difference in disease-free survival rates at 3 year between patients with postoperative TACE and non-TACE. Postoperative TACE has been demonstrated effective in increasing disease-free survival. Our study has shown that postoperative TACE appears to be useful in the prevention of the recurrence of HCC. 【Key words】 hepatocellular carcinoma transcatheter arte