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目的了解预防性经导管动脉化疗栓塞(TACE)对不同肿瘤生物学特性肝癌的抗复发作用。方法1996年10月至2001年9月,对收治的823例肝癌患者进行了肝癌切除术,其中126例(15.3%)术后行预防性TACE。以肿瘤生物学特性的不同将患者进行分组,评价预防性 TACE 对具有不同生物学特性的肝癌患者的抗复发作用。结果对于肿瘤直径≤3 cm 的患者,术后实施 TACE 并未能降低其复发率,反而可能导致肝功能损害,给之后治疗手段的选择带来限制;而对肿瘤直径为>3～10 cm、甲胎蛋白(AFP)阳性且伴有血管侵犯和肿瘤直径≥10 cm、伴有 AFP 阳性、存在子灶和血管侵犯、手术切缘<1 cm 的患者,则建议术后在系统情况良好、肝功能恢复后尽早行 TACE。结论术后 TACE 对具有术后复发高风险的患者具有降低复发率延长生存时间的作用。
Objective To investigate the anti-relapse effect of prophylactic transcatheter arterial chemoembolization (TACE) on hepatocarcinoma of different tumor biological characteristics. Methods From October 1996 to September 2001, 823 patients with liver cancer underwent hepatectomy. TACE was performed in 126 patients (15.3%) after operation. Patients were divided into groups according to their biological characteristics and evaluated the anti-relapse effect of prophylactic TACE on patients with liver cancer with different biological characteristics. Results For patients with tumor diameter ≤3 cm, TACE after operation did not reduce the recurrence rate, but could lead to liver damage, which restricted the choice of treatment. However, for patients with tumor diameter> 3-10 cm, AFP positive and associated with vascular invasion and tumor diameter ≥ 10 cm, with AFP-positive, presence of sub-lesions and vascular invasion, surgical margin <1 cm in patients with the proposed postoperative system in good condition, liver TACE as soon as possible after the functional recovery. Conclusions TACE has the effect of reducing recurrence rate and prolonging survival time in patients with high risk of postoperative recurrence.