摘要
目的通过倾向指数平衡混杂因素,评价手术切除(SR)和经导管肝动脉化疗栓塞(TACE)两种方法治疗早期原发性肝癌(HCC)患者的疗效。方法收集2003至2011年间在山东省肿瘤医院接受SR或TACE治疗的早期HCC患者350例,其中接受SR患者192例,接受TACE患者158例。采用倾向指数卡钳匹配法均衡组间的协变量,对匹配后的数据进行生存分析,比较两组的生存率。结果倾向指数匹配前,两组间协变量不均衡,SR组的1年、2年、3年、4年生存率分别为80.92%、49.44%、33.73%、19.72%,中位生存期为2.00年;TACE组的1年、2年、3年、4年生存率分别为80.02%、53.92%、31.21%、13.42%,中位生存期为2.40年;log-rank检验结果表明SR与TACE两组生存曲线差异无统计学意义(P=0.710 8)。倾向指数匹配之后,两组间协变量均衡;SR组的1年、2年、3年、4年生存率分别为84.22%、57.68%、36.80%、24.09%,中位生存期为2.50年;TACE组的1年、2年、3年、4年生存率分别为73.84%、47.26%、28.31%、10.69%,中位生存期为2.00年;log-rank检验结果表明两组间生存曲线的差异有统计学意义(P=0.018 2),SR组的生存率高于TACE组。结论采用倾向指数匹配法降低混杂偏倚后,SR对早期HCC患者的治疗效果优于TACE。
Objective To balance the covariates by propensity score matching for better evaluating the efficiencies of surgery resection（SR） and transcatheter arterial chemoembolization（TACE） for treatment of early-stage hepatocellular carcinoma（HCC） patients.Methods A total of 350 early-stage HCC patients treated by SR（192 cases） or TACE（158 cases） were collected from Shandong Tumor Hospital（2003 to 2011）.Propensity score caliper matching was used to balance the covariance between the two groups.And then the matched data were subjected to survival analysis and the survival rates were compared between the two groups.Results The covariates were imbalanced before matching;the 1-,2-,3-,and 4-year survival rates and the median survival time of SR group were 80.92%,49.44%,33.73%,19.72%,and 2.00 years,respectively;those of TACE group were 80.02%,53.92%,31.21%,13.42%,and 2.40 years,respectively;and log-rank test showed no significant differences in the survival rates between the two treatment groups（P=0.710 8）.The covariates were balanced after matching;the 1-,2-,3-,and 4-year survival rates and the median survival time of SR group were 84.22%, 57.68%,36.80%,24.09%,and 2.50 years,respectively;those of TACE group were 73.84%,47.26%,28.31%,10.69%,and 2.00 years,respectively;and log-rank test showed significant difference in the survival rates between the two groups（P=0.018 2）.The survival rate of SR group was higher than that of TACE group.Conclusion After reducing the confounding bias by Propensity score matching method,SR showes a better efficiency for early HCC patients compared with TACE.
出处
《第二军医大学学报》
CAS
CSCD
北大核心
2012年第10期1090-1094,共5页
Academic Journal of Second Military Medical University
基金
国家自然科学基金(81141112
81101290)
山东省自然科学基金(ZR2009CM117)~~
关键词
倾向指数
匹配法
肝肿瘤
生存分析
肝切除术
经导管肝动脉化疗栓塞
propensity score
matching method
liver neoplasms
survival analysis
hepatectomy
transcatheter arterial chemoembolization
