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目的 评价影响中晚期原发性肝癌 (以肝动脉化疗栓塞术 (TACE)为主的多模式治疗 )远期疗效的因素。方法 对曾采用TACE在内的多模式治疗的 89例中晚期原发性肝癌 ,选择 15个变量 ,行Cox回归模型分析影响远期疗效的因素。结果 单因素Cox回归模型分析结果显示肿瘤在肝内侵犯范围、肿瘤直径、组织类型及TACE次数有显著意义 (P <0 0 5 )。Kaplan Meier法计算累积中位生存期为 45个月 ,1～ 5年生存率分别为 :77 0 6 %、6 3 31%、5 1 6 9%、2 3 19%、14 5 9%。单纯TACE组总的生存率 ,长于手术 +TACE组 (P <0 0 5 )。结论 多因素分析和单因素分析均包含了肿瘤在肝内侵犯范围和肿瘤直径两项因素 ,说明此两项指标是影响原发性肝癌多模式治疗预后的重要因素
Objective To evaluate the factors that affect the long-term efficacy of advanced hepatocellular carcinoma (TACE)-based multimodal therapy. METHODS: Of the 89 patients with advanced liver cancer who had undergone multimodal treatment including TACE, 15 variables were selected. The Cox regression model was used to analyze the factors affecting long-term efficacy. Results The results of single factor Cox regression analysis showed that the extent of tumor invasion, tumor diameter, tissue type and TACE times were significant (P < 0.05). Kaplan Meier method calculated the cumulative median survival time was 45 months, 1 to 5 year survival rates were: 77 0 6 %, 63 3 31%, 5 16 9 %, 23 19%, 14 5 9 %. The overall survival rate of the TACE group alone was longer than that of the surgery+TACE group (P < 0.05). Conclusion Both multivariate analysis and univariate analysis included two factors of intratumoral tumor invasion and tumor diameter, indicating that these two indicators are important factors affecting the prognosis of multi-modality hepatocellular carcinoma.