辅助性TACE改善了双表型肝细胞癌切除后的预后:一种倾向性得分匹配研究
Zijian Leng1, Taifeng Zhu1, Ziyue Huang1
1Department of Liver Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, People's Republic of China.
Journal of hepatocellular carcinoma
|October 6, 2025
概括
手术后的辅助性转动脉化学栓塞 (TACE) 显著改善了双现型肝细胞癌 (DPHCC) 的结果. 这种治疗可以减少复发,并延长这种侵袭性肝癌患者的生存期.
科学领域:
- 肝胆道手术 肝胆道手术
- 手术瘤学手术瘤学
- 胃肠病学 胃肠病学
背景情况:
- 双现型肝细胞癌 (DPHCC) 是一种罕见的,具有不良预后的侵袭性肝癌.
- 在DPHCC的手术切除后,辅助性跨动脉化学栓塞 (TACE) 的疗效仍然不确定.
- 了解治疗效益对于管理这种具有挑战性的HCC亚型至关重要.
研究的目的:
- 评估辅助性跨动脉化学栓塞 (TACE) 对切除双现型肝细胞癌 (DPHCC) 患者的结局的影响.
- 评估术后TACE在改善DPHCC患者无复发生存期 (RFS) 和整体生存期 (OS) 中的作用.
主要方法:
- 对436名DPHCC患者进行治疗切除的回顾性分析 (2013-2023年).
- 276名接受辅助TACE治疗的患者和160名仅接受手术的患者之间的比较.
- 倾向性得分匹配为生存分析 (Kaplan-Meier,Cox模型) 创建了平衡的队列 (210 TACE,134 观察).
主要成果:
- 与单独观察相比,辅助TACE显著改善了无复发生存率 (RFS) 和总生存率 (OS).
- 在匹配的队列中,TACE 降低了复发风险 32% (HR 0.678,P=0.032) 和死亡风险 47% (HR 0.533,P=0.026).
- 多变量分析确定辅助TACE作为一个独立的保护因素;毒性通常是轻微的.
结论:
- 治疗切除后的辅助TACE大大减少了复发,并提高了DPHCC患者的长期存活率.
- 这些发现支持将TACE纳入高风险DPHCC的术后管理.
- 未来的试验有必要证实这些有益的结果.
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