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首页> 美国卫生研究院文献>Journal of Cancer >Risk factors of extra-hepatic progression after transarterial chemoembolization for hepatocellular carcinoma patients: a retrospective study in 654 cases
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Risk factors of extra-hepatic progression after transarterial chemoembolization for hepatocellular carcinoma patients: a retrospective study in 654 cases

机译：肝癌患者经动脉化疗栓塞术后肝外进展的危险因素：一项回顾性研究共654例

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>Aim: To investigate the risk factors of extra-hepatic progression after TACE in HCC.>Methods: The study population included 654 HCC patients who underwent TACE between October 2005 and September 2012. We collected and analyzed their clinical characteristics and survival information. TACE was performed as previously described with minor modifications. When necessary, superselective chemoembolization was performed through the segmental or subsegmental arteries, based on the tumor location and extent and hepatic function reserve. If stasis could not be achieved in a tumor-feeding artery, iodized oil was used solely in some patients. Embolization was then performed with injection of absorbable gelfoam particles (1-2 mm in diameter) through the angiographic catheter.>Results: The tumor response to initial TACE was evaluated in 645 patients. The CR rate, response rate (RR), and disease control rate (DCR) were 9.92%, 25.89%, and 70.39%, respectively. The median overall survival (OS) period was 14.5 months. The 6-month, 1-, 2-, 3-, and 5-year OS rates were 75.5%, 55.0%, 33.9%, 22.8%, and 14.9%, respectively. The median progression-free survival (PFS) period was 4.3 months. The 6-month, 1-, 2-, 3-, and 5-year PFS rates were 40.7%, 27.1%, 16.7%, 13.9%, and 9.3%, respectively. One hundred and fifty patients developed extrahepatic progression during follow-up. We demonstrated that in the absence of radical treatment after initial TACE (p<0.001), the presence of extrahepatic metastasis before initial TACE (p<0.001), AST >45 U/L (p=0.024), ALB <35 g/L (p=0.012), and tumor response were evaluated as PD and SD after initial TACE (p<0.001) and were found to be independent predictors of a poorer prognosis of extrahepatic PFS.>Conclusions: We identified risk factors for extrahepatic progression after TACE in HCC patients. Early combination treatment was strongly recommended in patients that met these risk factors.
机译：>目标：调查HACE中TACE后肝外进展的危险因素。>方法：研究人群包括654位在2005年10月至2012年9月期间接受TACE的HCC患者。我们收集并分析了它们的临床特征和生存信息。如前所述进行了TACE，但进行了较小的修改。必要时，根据肿瘤的位置，范围和肝功能储​​备，通过节段或节段动脉进行超选择性化学栓塞。如果无法在喂食肿瘤的动脉中达到停滞状态，则仅在某些患者中使用碘油。然后通过血管造影导管注入直径为1-2 mm的可吸收明胶泡沫颗粒进行栓塞。>结果：在645例患者中评估了对初始TACE的肿瘤反应。 CR率，缓解率（RR）和疾病控制率（DCR）分别为9.92％，25.89％和70.39％。中位总生存期为14.5个月。 6个月，1、2、3和5年的OS率分别为75.5％，55.0％，33.9％，22.8％和14.9％。中位无进展生存期（PFS）为4.3个月。 6个月，1、2、3和5年的PFS率分别为40.7％，27.1％，16.7％，13.9％和9.3％。一百五十名患者在随访期间出现肝外进展。我们证明了在初始TACE后未进行根治性治疗（p <0.001），在初始TACE前存在肝外转移（p <0.001），AST> 45 U / L（p = 0.024），ALB <35 g / L （p = 0.012），并且在初始TACE后将肿瘤反应评估为PD和SD（p <0.001），并且被发现是肝外PFS预后较差的独立预测因素。>结论：我们确定了风险肝癌患者行TACE后肝外进展的影响因素。强烈建议在符合这些危险因素的患者中进行早期联合治疗。

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