中国实用外科杂志

中国实用外科杂志

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局部消融治疗术后单发复发肝细胞癌长期生存研究

史瑶平，池嘉昌，施东华，王    涛，崔    丹，王    智，翟    博   

  1. 上海交通大学医学院附属仁济医院肿瘤介入科，上海200025
  • 出版日期:2020-06-01 发布日期:2020-06-24

  • Online:2020-06-01 Published:2020-06-24

摘要： 目的    评估局部消融治疗术后单发复发肝细胞癌（rHCC）病人的远期生存及预后因素。方法    回顾性分析上海交通大学医学院附属仁济医院2010年10月至2018年12月行局部消融治疗的73例单发rHCC病人的临床资料，采用Kaplan-Meier法绘制生存曲线、COX等比例风险模型进行生存预后因素分析。结果    病人消融术后平均生存时间为62.3个月，1、3、5年的累积存活率分别为97.1%、67.5%、49.3%，多因素分析显示消融前甲胎蛋白水平、肿瘤位置是影响病人生存的独立因素。结论    局部消融治疗术后单发rHCC疗效确切，具有良好的远期生存期，消融术前甲胎蛋白＞20 μg/L及肿瘤位于高危部位是导致病人生存时间缩短的独立危险因素。

关键词: 复发性肝癌, 消融, 临床疗效, 预后因素

Abstract: Long-term survival of local ablation for single recurrent hepatocellular carcinoma after liver resection        SHI Yao-ping, CHI Jia-chang, SHI Dong-hua, et al. Department of Interventional Oncology, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200025，China
Corresponding author： ZHAI Bo，E-mail：zhaiboshi@sina.com
Abstract    Objective    To evaluate the long-term survival and prognostic factors of local ablation therapy for single recurrent hepatocellular carcinoma（rHCC）after liver resection. Methods    The treatment and survival parameters of 73 patients with single rHCC who had received percutaneous ablation in Renji Hospital, Shanghai Jiaotong University School of Medicine from October 2010 to December 2018 were analyzed retrospectively. Kaplan Meier method was used to draw survival curve and Cox proportional risk model was used to analyze survival prognosis factors. Results    The mean overall survival（OS）time was 62.3 months，with 1-，3-，and 5-year cumulative survival rates of 97.1%，67.5% and 49.3%，respectively. Pre-ablation AFP and tumor location were found as independent predictors for OS at multivariate analysis. Conclusion    Local ablation therapy is effective treatment for single rHCC，with a favorable long-term outcome. Serum AFP＞20 μg/L and tumor located at high-risk site have a significant negative effect on overall survival.

Key words: recurrent hepatocellular carcinoma, ablation, clinical efficacy, prognostic factor