| 摘要: |
| 目的:比较手术治疗与介入治疗对原发多灶性肝癌患者的治疗效果。方法:回顾分析安庆市第一人民医院普外科、介入科和上海东方肝胆外科医院肝外五科2012 年1 月—2016 年12 月收治的139 例原发多灶性肝癌首诊患者(安庆市第一人民医院69 例，上海东方肝胆外科医院70 例)。采用Cox 比例风险模型进行预后相关文献因素的回归分析。结果:本组139 例患者中手术治疗组患者68 例(安庆市第一人民医院31 例，上海东方肝胆外科医院37 例)，介入治疗组患者71 例(安庆市第一人民医院36 例，上海东方肝胆外科医院35 例)。手术治疗组患者的1 年、3 年和5 年生存率分别为92.6%、45.4%、20.8%，中位生存时间为34(95% CI :29~44)个月。介入治疗组患者的1 年、3 年和5 年生存率分别为77.5%、16.5%、2.4%，中位生存时间为19(95% CI :15~23)个月。手术治疗组患者的总体生存时间明显长于介入治疗组(HR=2.27，95% CI :1.55~3.31，P <0.001)。相比介入治疗，手术治疗能显著延长Ib 期及IIa 期患者的总体生存时间，但手术治疗未能使IIb 期患者显著获益。多因素回归分析显示，影响患者总体生存时间的独立危险因素包括甲胎蛋白水平≥ 400 ng/mL、肿瘤数目≥ 4 个、超出米兰标准和肿瘤治疗方法。结论:对于肿瘤数目在3 个以内的肝癌患者，手术治疗疗效优于介入治疗。 |
| 关键词: 手术治疗 介入治疗 多灶肝癌 疗效 对比 |
| DOI：10.3969/j.issn.1007-6948.2020.03.024 |
| 投稿时间：2020-01-01 |
| 基金项目: |
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| Comparative Analysis of the Efficacy of Surgery and Intervention in the Treatment of Primary Multiple Liver Cancer |
| LI Hao,JIANG Mou-ying,XU Zhu-ding |
| Department of General Surgery, Anqing First People’s Hospital, Anqing (246004), China |
| Abstract: |
| Objective Patients with primary multiple hepatocellular carcinomas (HCCs) often has a poor prognosis, the surgical indications for primary multiple HCCs remain controversial. The aim of the study is to evaluate the survival benefits of liver resection compared with trans-arterial chemoembolization (TACE) for patients with multiple hepatocellular carcinomas (HCCs). Methods A retrospective analysis was conducted on 139 patients with multiple liver cancer admitted to the department of general surgery of Anqing first people’shospital, department of interventional medicine of Anqing first people’s hospital and the fifth department of hepatobiliary surgery of Shanghai Easternl hepatobiliary surgery hospital from January 2012 to December 2016 |
| Key words: Surgery interventional treatment multiple liver cancer ef?cacy comparison. |
