从现实生活的人群经历：肝癌患者预后以下肝动脉化疗栓塞

StephenW

Experience from a real-life cohort: outcome of patients with hepatocellular carcinoma following transarterial chemoembolization
Martha M Kirstein, Nora Schweitzer, Nazli Ay, Christina Boeck, Katerina Lappas, Jan B Hinrichs, Torsten Voigtländer, Frank Wacker, Michael P Manns, Thomas Rodt & Arndt Vogel

Journal
Scandinavian Journal of Gastroenterology
Page 1-22 | Received 27 Jul 2016, Accepted 02 Sep 2016, Accepted author version posted online: 06 Sep 2016, Published online: 06 Sep 2016

    Download citation http://dx.doi.org/10.1080/00365521.2016.1233579
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Abstract

Background: Hepatocellular carcinoma (HCC) is one of the most lethal cancers. Transarterial chemoembolization (TACE) has been accepted as the standard of care for intermediate stage disease.

Methods: In this study, we characterized 606 HCC patients from Hannover Medical School treated with TACE.

Results: 606 HCC patients treated with TACE were identified between 2000 and 2015. Most patients (59.8%) were at intermediate stage. Following TACE, most patients subsequently received systemic therapy or best supportive care (BSC), whereas 227 (37.5%) patients were bridged to potentially curative local treatments. Depending on subsequent therapies median post-TACE survival ranged from 7-162 months. Ascites, cholinesterase, c-reactive and alpha-feto protein and tumor size were identified as prognostic factors. These factors as well as the HAP, mHAP-II and STATE score also determined post-TACE survival independent of subsequent therapies. Hepatic function progressively deteriorated with repeated TACE sessions. Despite that, post-TACE survival was not shortened in frequently treated patients (≥5 times) as compared to patients treated 4 times or less (p = n.s.). Patients treated ≥5 times with TACE received significantly more often systemic therapy following TACE (37.3%) as compared to patients with 3-4(30.1%), 2(27.4%) and 1(21.8%) sessions (p < 0.05).

Conclusion: TACE is performed in a heterogenous population as bridging therapy to other local treatments and as palliative therapy. The long-term survival following TACE is determined by baseline tumor and patient related factors and by subsequent therapies. Post-TACE survival is not shorter in patients with frequent treatments (≥5) and the rate of subsequent systemic treatments is higher compared to less frequently treated patients.
Keywords: hepatocellular carcinoma, TACE, prognosis, score, liver transplantation,

StephenW

从现实生活的人群经历：肝癌患者预后以下肝动脉化疗栓塞
玛莎中号柯尔斯坦，诺拉史怀哲，纳兹勒哎，克里斯蒂娜BOECK，卡捷琳娜Lappas，扬乙Hinrichs先生托斯滕福伦达，弗兰克瓦克，迈克尔·P曼斯，托马斯Rodt和阿恩特沃格尔

日志
斯堪的纳维亚胃肠病学杂志
1-22页|收到2016年7月27日，接受2016年9月2日，笔者接受的版本在网上发布：2016年9月6日，在线发表时间：2016年9月6日

    下载引文http://dx.doi.org/10.1080/00​​365521.2016.1233579
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抽象

背景：肝细胞癌（HCC）是最致命的癌症之一。肝动脉化疗栓塞（TACE）已被接受为护理标准的中间阶段的疾病。

方法：在本研究中，我们的特点与TACE治疗从汉诺威医学院606肝癌患者。

结果：TACE治疗的606例HCC患者被确定2000年和2015年，大多数患者（59.8％）是在中间级之间。继TACE，多数患者随后收到的全身性治疗或最佳支持治疗（BSC），而227（37.5％）患者桥接可能治愈局部治疗。根据随后的治疗中位数TACE后生存期从7-162个月〜。腹水，胆碱酯酶，c-反应和α-胎儿蛋白和肿瘤大小被确定为预后因素。这些因素还有HAP，MHAP-II和国家工作取得还确定后TACE生存的独立后续治疗。肝功能逐步反复TACE会恶化。尽管如此，TACE后存活率没有相比患者频繁治疗的患者（≥5次）缩短处理过的4倍或更小（p值= N.S.）。患者治疗≥5接收与TACE倍显著更经常全身治疗以下TACE（37.3％），为比较例3-4（30.1％），2（27.4％）和1（21.8％）的会话（P <0.05）。

结论：TACE是在异质群体作为过渡性治疗其他局部治疗和姑息性治疗的进行。长期存活以下TACE由基线肿瘤和病人相关因素，并通过后续的治疗决定。 -TACE后生存的病人是频繁的治疗（≥5）和随后的全身治疗率不较短是比较不常用治疗的患者高。
关键词：肝癌，TACE，预后，评分，肝移植，