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目的 评价术后采用肝动脉化疗栓塞 (TACE)对提高肝细胞癌患者术后无瘤生存率的价值。 方法 对 172 5例行肝细胞癌切除术的患者进行回顾性随访 ,资料完整者 14 5 7例 ,其中 2 0 9例术后行TACE。对肿瘤子灶、血管侵犯、肿瘤包膜完整、小肝癌 (≤ 5 0cm)和肝硬化与否 10个因素分组 ,每组再按术后是否行TACE分别进行无瘤生存分析。采用SAS 6 12和EGRET软件 ,以Kaplan Meier法计算无瘤生存率 ,χ2 检验进行显著性差异检验。 结果 肿瘤包膜完整和无肝硬化 2组术后行TACE与未行TACE的无瘤生存率比较差异无显著意义 (χ2 =2 34,χ2 =0 0 6 ,P >0 0 5 )。其他 8个因素组中术后有无行TACE间生存率比较 ,差异有显著意义 ,P值均 <0 0 5。予TACE者无瘤生存率明显高于未行者。 结论 除病理结果提示肿瘤包膜完整和无肝硬化的患者之外 ,肝切除术后给予TACE将有助于提高患者术后的无瘤生存率 ,对提高手术疗效具有重要意义
Objective To evaluate the value of postoperative tumor-free survival in patients with hepatocellular carcinoma treated with transcatheter arterial chemoembolization (TACE). Methods A total of 172 5 hepatocellular carcinoma resections were retrospectively reviewed. There were 147 cases with complete data, of which 209 cases underwent TACE after operation. Tumor-free survival analysis was performed on tumor foci, vascular invasion, complete tumor capsule, small hepatocellular carcinoma (≤50 cm) and cirrhosis or not. The SAS 6 12 and EGRET software were used to calculate the tumor-free survival rate using the Kaplan Meier method. Theχ2 test was used to test the significant difference. Results There was no significant difference in the tumor-free survival between TACE and non-TACE after operation (χ2 = 2 34, χ2 = 0 06, P> 0.05). There was significant difference in the survival rate of TACE in the other 8 factors group after operation (P <0.05). TACE-free survival rate was significantly higher than those who did not walk. Conclusion In addition to the pathological findings suggest that patients with complete tumor capsule and no liver cirrhosis, TACE after hepatectomy will help to improve the patient’s postoperative tumor-free survival rate, to improve the efficacy of surgery is of great significance