The aim of this study was to retrospectively evaluate the effects of conventional transarterial chemoembolization (cTACE) for the treatment of hepatocellular carcinoma over 20 years regarding overall survival (OS) and prognostic factors for OS. During the period from 1996 to 2016, 836 patients with HCC were treated with cTACE. Data evaluation was performed on the basis of pre- and postinterventional MRI and CT scans. Survival analysis was performed by Kaplan–Meier estimator; prognostic factors were determined by the use of Cox regression analysis. Overall, 4084 (mean 4.89 TACE sessions/patient) procedures were assessed. Median OS was 700 days (99% CI, 632.8–767.2). Depending on the indication, patients treated with a neoadjuvant intention showed the best OS (1229 days, 99% CI 983.8–1474.2) followed by curative intention (787 days, 99% CI 696.3–877.7), and then palliative intention (360 days, 99% CI 328.4–391.6). Portal vein thrombosis (HR 2.19, CI 1.63–2.96, andp< 0.01) and Child–Pugh class B or worse (HR 1.44, CI 1.11–1.86, andp< 0.001) were significantly associated with shorter OS. Patients with HCC benefit from TACE after careful patient selection. Portal vein thrombosis and Child–Pugh class B or worse are significantly unfavorable prognostic factors for patients’ survival.
本研究旨在回顾性评估传统经动脉化疗栓塞术（cTACE）治疗肝细胞癌超过20年对总生存期（OS）的影响及其预后因素。1996年至2016年间，共有836例肝细胞癌患者接受了cTACE治疗。数据评估基于介入前后的磁共振成像和计算机断层扫描结果。生存分析采用Kaplan-Meier估计法进行；预后因素通过Cox回归分析确定。总体评估了4084次手术（平均每名患者接受4.89次TACE治疗）。中位总生存期为700天（99%置信区间：632.8–767.2）。根据治疗目的，接受新辅助治疗意向的患者总生存期最佳（1229天，99%置信区间：983.8–1474.2），其次为根治性治疗意向（787天，99%置信区间：696.3–877.7），姑息性治疗意向患者生存期最短（360天，99%置信区间：328.4–391.6）。门静脉血栓形成（风险比2.19，置信区间1.63–2.96，p<0.01）及Child-Pugh分级B级或更差（风险比1.44，置信区间1.11–1.86，p<0.001）与较短总生存期显著相关。经过严格患者筛选后，肝细胞癌患者可从TACE治疗中获益。门静脉血栓形成及Child-Pugh分级B级或更差是影响患者生存的显著不利预后因素。
肿瘤(癌症)患者之家