摘要
【目的】比较中国人群不可切除中晚期肝癌的肝动脉化疗栓塞术后联合二期手术切除与单纯肝动脉化疗栓塞治疗的临床疗效。【方法】通过计算机和手工检索收集国内关于肝动脉化疗栓塞联合二期手术与单独肝动脉化疗栓塞治疗无法手术切除肝癌的临床对照研究文献。采用Revman 5.2软件,应用异质性检验分析,对符合纳入标准的17项文献研究进行Meta分析。【结果】与单纯肝动脉化疗栓塞比较,经肝动脉化疗栓塞联合二期手术治疗的中晚期肝癌患者术后1年及3年生存率较高,差异有统计学意义(RR=1.31、2.24,均P<0.05)。在相同化疗栓塞药物治疗的条件下,与单纯肝动脉化疗栓塞比较,肝动脉化疗栓塞联合二期手术治疗的中晚期肝癌患者术后1年及3年生存率较高,差异有统计学意义(RR=1.39、2.51,均P<0.05)。与单纯肝动脉化疗栓塞比较,肝动脉化疗栓塞联合二期手术治疗的中晚期肝癌患者术后1年复发率降低(RR=0.52),但差异无统计学意义(P>0.05),术后2年复发率降低(RR=0.68),差异有统计学意义(P<0.05)。【结论】肝动脉化疗栓塞联合二期手术治疗无法手术切除的肝癌患者远期疗效优于单独肝动脉化疗栓塞治疗,可有效提高患者生存率,降低复发率。
【Objective】To compare the clinical efficacy of hepatic artery chemoembolization combined with second-stage surgical resection and simple hepatic artery chemoembolization treatment for unresectable advanced liver cancer in the Chinese population.【Methods】A clinical controlled study literature was collected through computer and manual retrieval on the treatment of unresectable liver cancer using hepatic artery chemoembolization combined with second-stage surgery and hepatic artery chemoembolization alone in China.Using Revman 5.2 software and heterogeneity test analysis,a meta-analysis was conducted on 17 literature studies that met the inclusion criteria.【Results】Compared with simple hepatic artery chemoembolization,patients with advanced liver cancer treated with hepatic artery chemoembolization combined with second-stage surgery had higher 1-year and 3-year survival rates after surgery,with statistically significant differences(RR=1.31,2.24,all P<0.05).Under the same conditions of chemoembolization drug treatment,compared with simple hepatic artery chemoembolization,the 1-year and 3-year survival rates of patients with advanced liver cancer treated with hepatic artery chemoembolization combined with second-stage surgery were higher,and the difference was statistically significant(RR=1.39,2.51,all P<0.05).Compared with simple hepatic artery chemoembolization,the combination of hepatic artery chemoembolization and second-stage surgery treatment reduced the 1-year recurrence rate of advanced liver cancer patients(RR=0.52),but the difference was not statistically significant(P>0.05).The 2-year recurrence rate decreased(RR=0.68),and the difference was statistically significant(P<0.05).【Conclusion】The long-term efficacy of hepatic artery chemoembolization combined with second-stage surgery for unresectable liver cancer is superior to that of hepatic artery chemoembolization alone,which can effectively improve patient survival rate and reduce recurrence rate.
作者
侯明星
魏永刚
杨传玉
HOU Ming-xing;WEI Yong-gang;YANG Chuan-yu(General Surgery,Wenjiang District Hospital of Traditional Chinese Medicine,Chengdu Sichuan 611130)
出处
《医学临床研究》
CAS
2023年第5期675-679,共5页
Journal of Clinical Research
基金
四川省科技厅重点研发项目(编号:2019YFS0372)。
