目的探讨肝切除联合术中微波固化或经导管肝动脉栓塞(transcatheter arterial chemoembolization,TACE)对BCLC—B期肝细胞癌患者生存预后的影响。方法回顾性分析172例BCLC.B期患者资料,分为2组,分别接受手术联合微波固化(liver resection combined with microwave coagulation therapy,LR+MCT)组,107例及接受TACE治疗组,65例。分别比较2组患者术后30d的死亡率、中位生存期、近远期生存率及并发症等。结果2组患者院内死亡率比较差异无统计学意义(χ2=0.285,P=0.593),但LR+MCT组术后有更高的并发症发生率(χ2=4.694,P:0.03)。LR+MCT组比TACE组的总体中位生存期长,差异有统计学意义(r=9.135,P=0.003),但2组5年生存期差异无统计学意义(χ2=4.767,P=0.434)。结论微波固化联合肝切除术和TACE是一样安全,并且手术组能够获得更长的中位生存期和较高的早期生存率。
Objective To explore the prognosis of patients with BCLC-B hepatocellular carcinoma (HCC) receiving LR + MCT vs TACE. Methods BCLC-B HCC patients undergoing LR + MCT ( 107 cases) and TACE (65 cases) were retrospectively evaluated, in terms of 30-day mortality rate, the median survival, early and long term survival rate and complications. Results The hospital mortality rate was similar between the two groups (χ2 = 0. 285, P = 0. 593 ). However, the LR + MCT group were with a significantly higher postoperative complication rate than the TACE group (χ2 = 4. 694, P = 0.03 ). At the same time, the LR + MET group had significantly higher median survival rates (χ2 = 9. 135, P = 0. 003 ), but, there was no statistical difference for five-year survival (χ2 = 4. 767, P = 0. 434 ). Conclusions LR + MCT are as safe as TACE for patients with BCLC-B HCC, and it provides longer median survival rates.