首页|TACE联合肝切除术对BCLC B期肝癌患者疗效及安全性的影响

TACE联合肝切除术对BCLC B期肝癌患者疗效及安全性的影响

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目的 探讨肝动脉化疗栓塞(TACE)联合肝切除术对巴塞罗那临床肝癌(BCLC)分期B期肝癌患者疗效及安全性的影响。方法 选取河南省平顶山市第五人民医院普外科和云南省楚雄州人民医院肝胆外一科2012年1月至2020年5月收治BCLCB期肝癌患者92例,均行TACE联合肝切除术治疗,比较手术前后肝功能血清学指标和凝血酶原时间(PT),记录总生存时间和无进展时间,同时分析基线肝功能、术前TACE次数、末次TACE后甲胎蛋白(AFP)下降及mRECIST评价结果对无进展生存时间的影响。结果 入选患者术后1周谷草转氨酶(AST)、谷丙转氨酶(ALT)、总胆红素(TBil)及PT水平均高于基线、术前(P<0。05);术后1周和1个月白蛋白(Alb)水平均低于基线(P<0。05);术前AFP下降患者中位无进展生存时间长于AFP未见显著改变患者(P<0。05);术前CR+PR患者中位无进展生存时间长于SD+PD患者(P<0。05)。结论 TACE联合肝切除术治疗BCLCB期肝癌安全有效;其中末次TACE后AFP下降和术前mRECIST评价达CR+PR患者中位无进展生存时间更长。
Influence of TACE combined with hepatectomy on clinical efficacy and safety of patients with BCLC-B stage hepatocellular carcinoma
[Objective]To investigate the influence of TACE combined with hepatectomy on clinical efficacy and safety of patients with BCLC-B stage hepatocellular carcinoma.[Methods]Ninety-two patients with BCLC stage B liver cancer admitted to the Department of General Surgery of the Fifth People's Hospital of Pingdingshan in Henan Province from January 2012 to May 2020 were treated with TACE combined with hepatectomy.The serum indexes of liver function and prothrombin time(PT)before and after operation were compared,and the overall survival time and progression free time were recorded.The effects of baseline liver function,preoperative TACE times,AFP decline after the last TACE and mRECIST evaluation results on progression free survival time were analyzed.[Results]The levels of AST,ALT,TBil and PT in 1 week after operation of all patients were significantly higher than base line and before treatment(P<0.05).The levels of Alb in 1 week and 1 month after treatment of all patients were significantly lower than base line(P<0.05).The PFS of patients with AFP decrease before operation were significantly longer than patients without AFP decrease(P<0.05).The PFS of patients with CR+PR before operation were significantly longer than patients with SD+PD(P<0.05).[Conclusion]TACE combined with hepatectomy in the treatment of patients with BCLC-B stage hepatocellular carcinoma possess the good clinical effects and safety,and the patients with decreased AFP after the last TACE and CR+PR before operation evaluated by mRECIST have longer median progression-free survival time.

liver cancerTACEhepatectomyBCLC stagingclinical efficacysafety

岳朝富、王晓波

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河南省平顶山市第五人民医院普外科,河南平顶山 467000

云南省楚雄州人民医院肝胆外一科,云南楚雄彝族自治州 675000

肝癌 经动脉灌注化疗栓塞(TACE) 肝切除术 巴塞罗那临床肝癌(BCLC)分期 疗效 安全性

2024

中国医学工程
中国医药生物技术协会 卫生部肝胆肠外科研究中心

中国医学工程

影响因子:0.504
ISSN:1672-2019
年,卷(期):2024.32(7)