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肝细胞癌伴门静脉癌栓患者术后tace辅助治疗-ag捕鱼平台

文字: 2018-6-21    浏览次数:780    

 

background. it remains uncertain whether patients with hepatocellular carcinoma (hcc) and portal vein tumor thrombus(pvtt) benefit from postoperative adjuvant trans-arterial chemoembolization(pa-tace).

背景:肝细胞癌(hcc)伴有门静脉癌栓(pvtt)的患者是否能从术后辅助肝动脉栓塞化疗(pa-tace)中获益尚未明确。

methods. we retrospectively identified 540 patients to form the crude cohort and adopted propensity score matching analysis to assemble another cohort of 464 patients with similar baseline characteristics.univariate and multivariate cox analyses were performed in explor atorysubgroups to identify the independent effect of pa-tace on overall survival(os).

方法:回顾性收集了540例患者作为原始队列,对464例基线特征相似的患者采用倾向评分匹配分析形成另一个队列。对探索性亚组进行单因素和多因素cox分析,以明确pa-tace对os的独立效应。

results. in the overall study population, univariate analysis showed pa-tace was associated with longer os [odds ratio (or) = 0.55,p = 0.001], and stratified analyses indicated an interaction between pvtt typesand patace on os (p = 0.057 for interaction). after matching, all of the characteristics were well balanced between the pa-tace and control groups (allp[ 0.05). multivariate cox analysis validated that the protective role of pa-tace was significant greater with the expansion of pvtt (type i, or 0.66;type ii, or 0.33; and type iii, or 0.33, respectively, p = 0.011 forinteraction). there also was evidence of treatment effect modification by pvtt type in the crude cohort (type i, or 0.60; type ii, or 0.32; and type iii, or0.32, respectively, p = 0.011 for interaction).

结果:在研究总人群中,单因素分析显示pa-tace治疗os更长[比值比(or) = 0.55,p = 0.001]。分层分析显示,pvtt类型与pa-tace治疗对os的影响相关(交互作用p=0.057)。配对后,pa-tace组和对照组的特征均做到了平衡(所有p>0.05)。多因素分析证实pa-tace的作用随着pvtt的扩大而显着增加(i型,or 0.66;ii型,or 0.33;iii型,or 0.33,交互作用p = 0.011)。也有证据表明在原始队列中,pvtt类型影响治疗效果(i型,or 0.60;ii型,or 0.32;iii型,or 0.32,交互作用p = 0.011)。

conclusions. in patients with hcc and pvtt, pa-tace was associated with a lower risk of death, particularly, among those with pvtt involving right/left or main portal vein, after excluding patients who were unsuitable for this procedure at 1 month after surgery.

结论:排除术后1个月不适合pa-tace的患者后,hcc伴pvtt的患者接受pa-tace可以降低死亡风险,特别是涉及门静脉主干或右/左支的pvtt。