对破裂性肝细胞癌的治疗方法进行比较分析,并确定对生存的成像预测因子
Natthaphong Nimitrungtawee1, Phichayut Phinyo2,3,4, Piemkamol Chalidapong1
1Department of Radiology, Diagnostic Radiology Unit, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
BMC cancer
|August 25, 2024
概括
肝细胞癌 (rHCC) 的自发破裂是致命的,但与最佳支持性护理 (BSC) 相比,跨动脉栓塞 (TAE) 和手术显著提高了存活率. 建议对rHCC患者进行积极的治疗.
科学领域:
- 肝胆道手术是肝胆道的手术.
- 干预性放射学是干预性的放射学.
- 在瘤学瘤学.
背景情况:
- 肝细胞癌 (rHCC) 的自发破裂是具有高死亡率 (25-75%) 的关键并发症.
- 治疗选择包括跨动脉栓塞 (TAE),手术和最佳支持性护理 (BSC),并讨论最佳选择.
- 成像在评估rHCC患者的预后方面发挥着至关重要的作用.
研究的目的:
- 为了比较治疗TAE,手术或BSC的rHCC患者的生存结果.
- 为了确定可预测rHCC患者生存的成像因素.
主要方法:
- 从2012年1月到2021年12月,对186名rHCC患者进行了回顾性审查.
- 用于平衡预处理混因素的逆概率治疗权重 (IPTW).
- 灵活的参数生存回归用于比较生存率并确定预后成像因素.
主要成果:
- 90天和1年的死亡率分别为64%和84%.
- 与BSC相比,TAE和手术都显著降低了1年死亡率 (HR分别为0.56和0.52).
- 与BSC相比,TAE和手术将预期寿命分别延长了约55天和68天. 两个叶片的活跃对比外流和出血是1年生存的独立预后因素.
结论:
- 对rHCC患者来说,TAE和手术治疗提供了可比的生存益处.
- 与最好的支持性护理相比,这两种干预措施都将生存时间延长约两个月.
- 强烈建议所有rHCC患者积极管理.
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