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术前化疗栓塞达到病理完全缓解的肝细胞癌患者术后生存结局得到改善:治疗反应的预测因素-ag捕鱼平台

文字: 2019-12-17    浏览次数:412    


background: we identified the predictive factors and prognostic significance of transarterial chemoembolization (tace) for achieving pathologic complete response (pcr) before curative surgery for hepatocellular carcinoma (hcc) in hepatitis b-endemic areas.

背景:我们确定了乙型肝炎流行地区肝细胞癌(hcc)患者术前经动脉化疗栓塞(tace)达到病理完全缓解(pcr)的预测因素及预后。

 

methods: among 753 hcc patients treated with surgery, 124 patients underwent preoperative tace before liver resection (lr), and 166 before liver transplantation (lt) between 2005 and 2016. overall survival (os) and recurrence-free survival (rfs) were analyzed. pathologic response (pr) was defined as the mean percentage of necrotic area, and pcr was defined as the absence of viable tumor.

方法:纳入2005-2016年间753例进行手术治疗的肝细胞癌患者,其中124例患者肝切除(lr)前行tace治疗,166例患者肝移植(lt)前行tace治疗。分析总生存(os)和无复发生存率(rfs)。病理反应(pr)定义为坏死面积的平均百分比,pcr定义为没有存活的肿瘤。

 

results: a total of 34 (27%) and 38 (23%) patients had pcr before lr and lt, respectively. alpha-fetoprotein (afp) < 100 ng/ml and single tumor were significant preoperative predictors of pcr.

os and rfs were significantly improved in patients with pcr or a pr ≥ 90%, but not in patients with pr ≥ 50% after lr and lt. on multivariate analyses, pr ≥ 90% remained an independent predictor of better os and rfs in lr and lt groups.

结果:分别有34(27%)38(23%)患者在lrlt前达到了pcr。甲胎蛋白(afp) < 100 ng/ml和单个肿瘤是pcr的重要术前预测因素。pcrpr≥90%的患者osrfs得到显著改善,而lrltpr≥50%的患者则没有得到显著改善。在多变量分析中,pr≥90%仍然是lrltosrfs改善的独立预测因素。

 

conclusion: overall, our data clearly demonstrate that pcr predicts favorable prognosis after curative surgery for hcc, and predictors of pcr are afp <100 ng/ml and single tumor.

结论:总之,我们的研究数据清晰地表明,pcr可以预测hcc术后良好的预后,并且afp < 100ng /ml及单个肿瘤是pcr的预测因素。