TACE治疗预防肝癌术后复发的临床分析

doi:10.3969/j.issn.1009-976X.2021.04.005

摘要/Abstract

摘要： 目的分析TACE在预防肝癌术后复发的作用,意在筛选出TACE对肝癌术后复发有预防作用的潜在受益人群。方法收集2014年1月至2018年11月在我院诊断为原发性肝细胞肝癌、并接受根治性切除手术的病人资料,总共205例。根据病人是否接受TACE治疗分为NO TACE组（74例）和TACE组（131例）;根据病人接受TACE治疗的时间点进行分组,分为NO TACE组（74例）、术前TACE组（32例）、术后TACE组（50例）和前后TACE组（49例）;根据性别、年龄、乙肝表面抗原等临床特征分为各亚组,回顾性分析TACE在治疗预防肝癌术后复发的作用。结果 TACE治疗不能显著降低整体肝癌患者的术后复发率（P>0.05）,但术后TACE治疗能够适当降低个别亚组病人的2年内肿瘤复发率,包括肿瘤直径>5 cm组、AFP>200 μg/L组、CNLC Ib期以上组、BCLC B级以上组病人,而对2年后的肝癌复发率则无明显影响。结论 TACE治疗不能显著降低整体肝癌患者的术后复发率,但术后TACE治疗能够适当降低个别高危复发风险病人的2年内肿瘤复发率。

关键词: TACE, 肝癌, 复发, 高危因素

Abstract: Objective To evaluate the effect of transarterial chemoembolization （TACE）on prevention of postoperative recurrence in patient with hepatocellular carcinoma （HCC）, and screen for the potential beneficiaries. Methods A total of 205 HCC patients underwent radical surgery between January 2014 and November 2018 were enrolled in the study. Patients were divided into subgroups, based on whether receiving TACE, time on receiving TACE, and clinical characteristics, to analyze the differences of recurrence-free survival （RFS）. Results TACE did not prolong RFS in patients with HCC（P>0.05）, but postoperative TACE could mildly reduce the 1- and 2-year recurrence rate in tumor >5 cm, Alpha-fetoprotein （AFP）>200 μg/L, China liver cancer staging （CNLC）Ibabove, Barcelona Clinic Liver Cancer （BCLC）B above subgroup patients, but not recurrence rate after 2 years. Conclusion TACE did not significantly reduce the RFS in patients with resectable HCC, but might reduce the early phase recurrence rate in HCC patients with high recurrence risk.

Key words: TACE, hepatocellular carcinoma, recurrence, high risk factor

中图分类号:

R735.7

伍隽华, 谭慧敏, 左超海, 邝乃乐, 余杰雄, 陈云扬. TACE治疗预防肝癌术后复发的临床分析[J]. 岭南现代临床外科, 2021, 21(04): 397-404.

WU Juan-hua, TAN Hui-min, ZUO Chao-hai, KUANG Nai-le, YU Jie-xiong, CHEN Yun-yang.. Analysis of TACE on prevention of postoperative recurrence in patient with hepatocellular carcinoma[J]. Lingnan Modern Clinics In Surgery, 2021, 21(04): 397-404.

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