肝癌经皮微波消融影响患者远期生存的多因素分析
来源: 2006-06-12 21:57:55

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  PURPOSE:To determine the long term survival and prognostic factors in patients with hepatocellular carcinoma treated with percutaneous microwave ablation.

  MATERIALS AND METHODS:Database of hepatocellular carcinoma in 288 patients was analysed.  Prognostic factors for survival were evaluated by univariate and multivariate analysis.

  RESULTS:1-,2-,3-,4-,and5-year cumulative survival rates of all 288 patients were 93%,82%,72%,63%and 51%,respectively. Age (P=0.84),gender(P=0.07),pre-ablation serum AFP level (P=0.14) and pre-ablation treatment (P=0.26) were not related to prognosis,while tumor number (P=0.004),tumor size (P<0.001),Child-Pugh classification (A,B,andC) (P=0.003),tumor differentiation (P=0.026),local recurrence or new tumors (P=0.004) significantly affected survival in univariate analysis.Multivariate analysis revealed that only tumor size(P<0.001),number of nodules (P=0.005),and Child-Pugh classification(P=0.01)each had a significant effect on survival.

  CONCLUSION:With microwave ablation,there is a high probability of long term survival for the patients with a single lesion of 4.0cm or less in maximum diameter,with Child-Pugh A cirrhosis.

 

  近10年来,影像引导下的局部热消融治疗作为肝癌的一种微创治疗技术,已得到了较广泛的应用[1~6]。但以往的国内外报道主要集中在对各种消融技术方法的可行性、安全性及治疗效果方面的评价。但影响肝癌病人远期生存的原因是多方面的,不仅与肿瘤的特性有关,也与病人的自身状态、肝功的情况相关。我们对在我院接受经皮微波消融治疗的288例肝癌患者共计477个结节进行了研究,观察了影响其预后的多种临床及病理因素并对其结果进行了统计学分析。

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