The aim of this study was to determine the local recurrence (LR) rate and identify factors associated with LR in patients who achieve a radiological complete response (CR) after undergoing balloon-occluded transcatheter arterial chemoembolization (B-TACE) for hepatocellular carcinoma (HCC). From November 2017 to September 2021, 60 patients (44 men, 16 women; mean age, 63.5 years; range, 39–82 years) with 72 HCCs (mean diameter, 31 mm; range, 10–50 mm) who underwent subsegmental B-TACE were included in this retrospective study. Radiological and clinical evaluation of oily subsegmentectomy, defined as radiological CR of the HCC and peritumoral parenchymal necrosis, was performed. The CR rate was 97.2% (70 of 72 HCCs) at first follow-up (mean, 41 days; range, 14–110 days). Overall, 13 HCCs (19.7%) demonstrated LR at a mean of 29.8 months (range, 3–63 months) and cumulative LR rates were 1.5% 14.2% 21%, 21%, and 21% at 6, 12, 24, 36, and 48 months, respectively. In 28 (38.9%) of 72 HCCs, oily subsegmentectomy was achieved, tumor markers were normalized, and LR did not occur. The oily subsegmentectomy-positive group had a significantly lower LR rate than the oily subsegmentectomy-negative group (p= 0.001). Age ≥65 years (adjusted hazard ration (HR), 0.124; 95% confidence interval (CI), 0.037–0.412;p< 0.001) and peripheral location (adjusted HR, 0.112; 95% CI, 0.046–0.272;p< 0.001) were independent predictive factors of LR. Subsegmental B-TACE can be an effective method with a high initial CR rate and low LR incidence. Oily subsegmentectomy can be considered as an index of successful treatment because it did not demonstrate any LR.
本研究旨在评估肝细胞癌（HCC）患者经球囊闭塞经导管动脉化疗栓塞术（B-TACE）后达到影像学完全缓解（CR）的局部复发（LR）率，并分析其相关影响因素。本研究回顾性纳入2017年11月至2021年9月期间接受亚段B-TACE治疗的60例患者（男性44例，女性16例；平均年龄63.5岁，范围39-82岁），共72个HCC病灶（平均直径31mm，范围10-50mm）。通过影像学及临床评估"油性亚段切除"效果，即HCC病灶及瘤周肝实质坏死达到影像学CR。首次随访（平均41天，范围14-110天）时CR率为97.2%（72个病灶中70个）。平均随访29.8个月（范围3-63个月）期间，共13个病灶（19.7%）出现LR，6、12、24、36及48个月的累积LR率分别为1.5%、14.2%、21%、21%和21%。72个病灶中有28个（38.9%）实现油性亚段切除且肿瘤标志物恢复正常，均未发生LR。油性亚段切除阳性组的LR率显著低于阴性组（p=0.001）。年龄≥65岁（校正风险比0.124；95%置信区间0.037-0.412；p<0.001）及病灶周边位置（校正风险比0.112；95%置信区间0.046-0.272；p<0.001）是LR的独立预测因素。亚段B-TACE是一种有效的治疗方法，具有较高的初始CR率和较低的LR发生率。油性亚段切除可作为治疗成功的指标，因其组内未观察到任何LR病例。
肿瘤(癌症)患者之家