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肝癌术后复发疗效和预后因素分析 |
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陆才德 彭淑牖 彭承宏 江献川
【摘 要】 目的 探讨肝癌术后复发的疗效和影响预后的因素。方法 收集1988～1996年收治的82例肝癌术后复发的临床和随访资料，回顾性分析其治 疗效果，应用Cox单因素和多因素回归模型，确定影响术后复发预后的因素。结果 肝癌术后复发大体病理可分为局部型、多发型和弥漫型。23例接受了肝和(或)肺的部 分切除术，27例接受了肝动脉栓塞化疗，21例接受了经静脉或肝动脉化疗，余未接受特殊治 疗。复发后1、3年和5年生存率切除组为78.3%，34.9%和23.3%；栓塞化疗组为37.0%，1 1.0%和0 ；化疗组为9.0%和0；未治疗组无1年存活者。Cox回归模型提示复发时间、复发类型、治疗 方法的选择及复发时有无肝和(或)门静脉癌栓是术后复发预后的相关因素。结论 重点预防肝癌术后的近期复发，对局部复发行手术切除，多发复发行肝动脉栓塞化疗 可有效延长生存期。
【关键词】 肝细胞癌 术后复发 治疗结果 预后因素
Results of the treatment for postoperative recurrences of hepatocellular carcino ma and risk factors in relation to their prognosis
Lu Caide,Peng Shuyou,Pe ng Chenghong,et al.
（Department of Surgery,the Second Affiliated Hospital,Zhejiang University,Medical Science,Hangzhou 310009）
【Abstract】 Objective To investigate results of the treatment fo r postoperative recurrences of hepatocellular carcinomas (HCCs) and their pr ognostic factors.Methods Clinical and follow up data from 82 patien ts with postoperative recurrence of HCC were reviewed and Cox regression mod el was employed to determine the risk factors in relation to their prognosis.Results Postoperative recurrences of HCC can be classified as local t ype,multiple type and diffuse type.Hepatic and/or lung resections were carried o ut on 23 patients and transcatheter arterial chemoembolizations (TAEs) were done on 27.Twenty-one patients received chemotherapy only and no special treatme nt for the others.The 1～,3～ and 5～ year survival rates after recurrence were 78.3%，34.9% an d 23.3% for patients in the resection group,37.0%，11.0% and 0 for patients i n the TAE group,and 9.0% and 0 for those received chemotherapy only.No one surv ived for 1 year in the untreated group.Cox regression model revealed that the pe riod for recurrence,the recurrent type,the selection for treatment and vein invasion were risk factors in relation to the prognosis of postoperative r ecurrence of HCC.Conclusion It is most important to prevent pat[1] [2] 下一页
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