8cm以上肝癌术后残癌的肝动脉栓塞化疗预后因素分析

目的：了解肝动脉栓塞化疗对直径大于8cm肝癌术后残癌的疗效和影响预后的因素。方法：肝癌切除术后2个月内经超声和动脉造影证实有残癌的肝癌患者，行肝动脉栓塞化疗；采用COX模型研究影响疗效的因素。结果：治疗后1，2，3，4年生存率为74.9%，44.2%，36.8%，18.4%。肝癌切除术后残癌的TNM分期是影响疗效的独立因素（P=0.003)。而原发癌的肿瘤分期，手术方式（局部切除或肝叶切除），肝动脉栓塞化疗的次数，不是影响预后的独立因素。结论：肝癌术后行肝动脉栓塞化疗是可行的，术后残癌的分期是影响肝动脉栓塞化疗效果的主要因素，大体积肿瘤术后尽早行肝动脉栓塞化疗是必要的。

The Prognostic Factor Analysis of Postoperative Arterial Chemoembolization for Hepatocellular Carcinoma

Objective:To study the effect and prognostic factors of transcatheter arterial chemoembolization(TACE)in hepatocellular carcinoma (HCC)patients after surgery.Methods:TACE was performed in HCC patients two months after cytoreductive surgery when residual tumor was identified by sonography and angiography.The COX model was used for analysis of prognos-tic factors after TACE treatment.Results:The1-,2-,3-and4-year survival rates were79.4%,44.2%,36.8%and18.4%respectively.The TNM stage of residual tumor(rTNM)was the signifi-cant factor to effect the prognosis(P=0.003)although the TNM stage of primary tumor(pTNM),alpha-fetoprotein of primary tumor,resection type,times of TACE were not significant factors.Conclusion:TACE is effective in the treatment of HCC with cytoreductive surgery and TACE should be performed after cytoreductive surgery as soon as possible because of the significance of rTNM stage in prognosis of the disease.