Prognostic impact of portal vein immunochemotherapy in patients after resection of primary hepatocellular carcinoma
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摘要:
目的观察门静脉免疫化疗对原发性肝癌切除后患者预后的影响。方法收集湖北医药学院附属太和医院2010年1月-2013年6月住院的48例手术切除并行术后门静脉免疫化疗患者,对其临床资料进行回顾性分析,并与同期未行门静脉免疫化疗的59例患者进行对比。计量资料的分析采用两样本资料的t检验,率的检验采用卡方检验。生存分析采用Kaplan-Meirer法计算平均生存时间,采用log-rank检验分析不同组之间的差异性。将107例患者合并,采用Cox回归模型分析对可能影响预后的因素进行多因素分析。结果免疫化疗组和对照组的1、2、3年的无瘤生存率分别为87.5%(42/48)和67.8%(40/59)(χ2=5.739,P=0.017)、52.1%(25/48)和32.2%(19/59)(χ2=4.320,P=0.038)、16.7%(8/48)和10.2%(6/59)(χ2=0.982,P=0.322),平均生存时间分别为(32.4±2.3)个月和(24.7±2.3)个月(χ2=4.044,P=0.044)。合并门静脉癌栓者术后行门静脉免疫化疗其平均生存时间(12.4±1.3)个月,而未行门静脉免疫化...
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关键词:
- 癌,肝细胞 /
- 化学疗法,肿瘤,局部灌注 /
- 肝切除术 /
- 门静脉
Abstract:Objective To observe the prognostic impact of portal vein immunochemotherapy in patients after resection of primary hepatocellular carcinoma (HCC) . Methods A retrospective analysis was performed on the clinical data of 48 patients who received portal vein immunochemotherapy after resection of primary HCC (immunochemotherapy group) and 59 patients who did not receive portal vein immunochemotherapy after resection of primary HCC (control group) . Continuous data were analyzed by two- sample t- test; rates were compared withχ2test. Survival analysis was performed by the Kaplan- Meirer method for calculating the mean survival time; the survival differences between the two groups were analyzed with the log- rank test. The prognostic factors in all the 107 patients were analyzed using a multivariate Cox regression model. Results The 1-, 2-, and 3- year disease- free survival (DFS) rates of the immunochemotherapy group and control group were 87. 5% (42 /48) vs 67. 8% (40 /59) (χ2= 5. 739, P = 0. 017) , 52. 1% (25 /48) vs 32. 2% (19 /59) (χ2= 4. 320, P =0. 038) , and 16. 7% (8 /48) vs 10. 2% (6 /59) (χ2= 0. 982, P = 0. 322) , respectively, and the mean survival time of the two groups was32. 4 ± 2. 3 months vs 24. 7 ± 2. 3 months (χ2= 4. 044, P = 0. 044) . Among the cases complicated by portal vein tumor thrombosis, those receiving postoperative portal vein immunochemotherapy had a mean survival time of 12. 4 ± 1. 3 months, versus 4. 8 ± 0. 4 months for those not receiving postoperative portal vein immunochemotherapy (χ2= 15. 535, P < 0. 001) . Cox regression analysis revealed that pathological differentiation, tumor size, liver function grade, and portal vein tumor thrombus were independent prognostic factors for the recurrence in patients after resection of primary HCC. Whether to receive portal vein immunochemotherapy is related to postoperative recurrence time (P < 0. 001) .Conclusion Portal vein immunochemotherapy could improve the DFS rate and survival time in patients after resection of primary HCC.
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