原发性肝癌伴门静脉癌栓行术后肝动脉化疗栓塞联合门静脉化疗的疗效观察

目的 评价原发性肝癌伴门静脉癌栓行术后肝动脉化疗栓塞联合门静脉化疗的临床疗效.方法 回顾性分析2000年1月至2004年12月获得随访的85例行手术治疗和术后化疗的原发性肝癌合并门静脉癌栓病人,其中64例病人术后仅行肝动脉化疗栓塞(A组),另外21例病人术后行肝动脉化疗栓塞联合门静脉化疗(B组).比较两组病人术后1、2和3年肝癌复发率和生存率.结果 A组术后1、2和3年肝癌复发率分别为56.3%、75.0%和85.9%,B组分别为28.6%、61.9%和81.0%.仅术后1年复发率B组显著低于A组(P<0.05),两组术后2、3年复发率比较无统计学差异(P>0.05).A组术后1、2和3年生存率分别为53.1%、43.8%和31.3%,B组分别为81.0%、61.9%和38.1%.B组术后1、2年生存率明显高于A组(P<0.05),两组术后3年生存率比较无统计学差异(P>0.05).结论 术后肝动脉化疗栓塞联合门静脉化疗能够明显降低原发性肝癌伴门静脉癌栓塞病人术后短期复发率,有助于提高近期疗效.

Therapeutic effect of postoperative transarterial chemoembolization and portal vein chemotherapy on primary liver cancer with portal vein tumor thrombus

Objective To investigate the therapeutic effect of postoperative transarterial chemo-embolization (TACE) and portal vein chemotherapy (PVC) on primary liver cancer with portal vein tumor thrombus (PVTT). Methods The clinical data of 85 patients with primary liver cancer with PVTT treated in our hospital from January 2000 to December 2004 were retrospectively analyzed. Of the 85 patients, 64 received mere TACE after operation (group A) and the other 21 underwent TACE and PVC postoperatively (group B). The 1-, 2- and 3-year postoperative recurrent and survival rates were compared between the 2 groups. Results The 1-, 2- and 3-year recurrent rates were 56.3%, 75.0% and 85.9% in group A and 28.6%, 61.9% and 81.0% in group B, respectively. Group B showed significantly lower 1-year postoperative recurrent rate as compared with group A (P<0.05). The 1-, 2- and 3-year survival rates were markedly higher in group B than in group A (81.0% vs 53.1%, 61.9% vs43.8%, 38.1% vs31.3%, P<0.05). Conclusion Postoperative TACE in com-bination with PVC may degrade short-term postoperative recurrent rate for the primary liver cancer with PVTT and improve the outcome in the near future.