邮件订阅 RSS 中文 | English
高级检索

肝细胞癌患者经动脉化疗栓塞治疗后长期生存的影响因素分析

Analysis of prognostic factors affecting long-term survival of patients with hepatocellular carcinoma after transcatheter arterial chemoembolization

    摘要
  • 摘要:
    目的 探讨肝细胞癌（hepatocellular carcinoma，HCC）患者经肝动脉化疗栓塞（transcatheter arterial chemoembolization，TACE）治疗后长期生存的预后因素。
    方法 收集2003年1月至2014年6月复旦大学附属中山医院介入科收治的HCC患者258例，按照生存时间分为长期生存组（生存期≥5年，n=150）和短期生存组（生存期 < 5年，n=108）。所有患者首次治疗均采用TACE，后续治疗为TACE治疗和（或）包括外科切除、其他介入治疗和靶向药物在内的综合治疗。采用多因素Cox回归模型分析影响HCC患者长期生存的主要因素。
    结果 长期生存组中位生存期为97个月（95% CI 84.5~109.5），短期生存组中位生存期为14个月（95% CI 10.4~17.6）。单因素分析结果显示，2组患者在肿瘤数目、肿瘤大小、肿瘤边界、AFP值、肿瘤分期、动静/门脉瘘、肝外转移、腹水、门脉受侵/癌栓、碘油沉积状态、肝外血供、肿瘤边界、综合治疗方面的差异均有统计学意义（P < 0.05）；Cox回归模型多因素分析结果显示，肿瘤数目≤3（HR=2.141，P < 0.01）、无门脉侵犯/癌栓（HR=3.554，P < 0.01）、碘油沉积状态Ⅰ型+Ⅱ型（HR=1.679，P=0.017）、综合治疗（HR=2.745，P < 0.01）是HCC患者TACE治疗后获得长期生存的独立影响因素。
    结论 HCC患者TACE及以TACE为主的综合治疗安全有效，TACE术前的肿瘤数目、门脉受侵/癌栓、TACE术后碘油沉积状态、综合治疗等是影响TACE治疗后长期生存的独立影响因素。

     

    Abstract:
    Objective To explore the prognostic factors that affect the long-term survival of hepatocellular carcinoma(HCC) patients after transcatheter arterial chemoembolization(TACE) treatment.
    Methods 258 patients with HCC treated in the Interventional Department of Zhongshan Hospital, Fudan University from January 2003 to June 2014 were collected. According to the survival time, they were divided into long-term survival group (survival time ≥ 5 years, n=150) and short-term survival group (survival time < 5 years, n=108). All patients were treated with TACE initially. While, some patients received further combined therapy, such as surgical resection, molecular targeted drugs, and/or other interventional procedures. The clinical data of the two groups of patients were retrospectively compared and analyzed to explore factors affecting the long-term survival of patients after TACE treatment.
    Results The median survival time of patients was 97 months in long-term survival group (95%CI 84.5~109.5), and 14 months in short-term survival group (95%CI 10.4~17.6). Univariate analysis showed that the number of tumors, tumor size, tumor boundary, AFP value, tumor stage, arteriovenous/portal fistula, extrahepatic metastasis, and portal vein invasion/portal vein tumor thrombus, lipiodol deposition status, extrahepatic tumor arterial blood supply, tumor borders, and accessibility to combined therapy are statistically significant (P < 0.05). Cox regression risk model showed that the number of tumors ≤ 3(HR=2.141, P < 0.01), uninvaded portal vein/no portal vein tumor thrombus(HR=1.679, P=0.017), lipiodol deposition state Ⅰ+Ⅱ(HR=3.554, P < 0.01), combined therapy(HR=2.745, P < 0.01) are independent factors influencing the long-term survival of HCC patients with TACE treatment.
    Conclusion TACE and combined therapy based on TACE are safe and effective treatments for HCC patients. The quantity of tumors before TACE, the portal vein invasion/portal vein tumor thrombus, the state of lipiodol deposition after TACE, and combined therapy are all independent factors which affecting the long-term survival of HCC patients.

     

    • HTML全文
    • 参考文献(26)
    • 相关文章
    • 施引文献
  • 资源附件(0)

/

返回文章
返回