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目的:探讨影响原发性肝癌术后行经肝动脉化疗栓塞(TACE)患者无瘤生存的因素。方法:回顾性分析121例手术切除后1~2个月内行TACE治疗的原发性肝癌患者的临床及随访资料,计算患者治疗后的累积无瘤生存率,分析影响无瘤生存的相关因素。结果:121例患者术后1,2,3年的无瘤生存率分别为72.73%,46.21%,28.93%。经单因素分析筛选后,进入COX比例风险模型的各临床变量中,肿瘤的分化程度(P=0.040),肿瘤大小(P=0.002)及有无血管癌栓(P=0.039)对模型贡献有统计学意义。结论:分化程度、肿瘤的大小及有无血管癌栓是影响肝癌术后行TACE近期复发的独立危险因素。
Objective: To investigate the factors influencing the tumor-free survival of patients with primary hepatocellular carcinoma after transcatheter arterial chemoembolization (TACE). Methods: The clinical and follow-up data of 121 patients with primary hepatocellular carcinoma treated with TACE within 1-2 months after resection were retrospectively analyzed. The cumulative tumor-free survival rate after treatment was calculated and the factors influencing disease-free survival were analyzed. Results: The 121-year survival rates after one, two and three years were 72.73%, 46.21% and 28.93% respectively. After univariate analysis, the differences in tumor differentiation (P = 0.040), tumor size (P = 0.002), and presence or absence of vascular thrombosis (P = 0.039) in each clinical variable entering the COX proportional hazard model contributed Statistical significance. Conclusion: The degree of differentiation, the size of tumor and the presence or absence of vascular thrombosis are independent risk factors for the recent recurrence of TACE after liver cancer surgery.