Effect of chronic liver disease using a multivariate analysis of associated risk factors in patients with hepatocellular carcinoma treated with transarterial chemoembolization

P. Farshid, Babak Bazrafshan, Alireza Azizi, E. Mbalisike, T. Vogl
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引用次数: 1

Abstract

Purpose: To evaluate the effect of chronic liver disease (CLD) in a multivariate analysis of associated risk factors in patients with hepatocellular carcinoma (HCC) using transarterial chemoembolization (TACE). Materials and methods: A total of 145 patients with HCC (99 men, 46 women; mean age: 63 years ±8.1; age range: 46-84 years) underwent 598 TACE procedures. The presence of CLD, number and location of lesions, tumor size, Child-Pugh score, vascularity, portal involvement and alpha fetoprotein value were analyzed using the multivariate regression model. Cox regression was used for survival analysis. Results: The median survival time was 26.7 months, and 78.6% of all treated lesions showed tumor responses. The presence of CLD (OR 2.12, P=0.004), Child-Pugh score B (OR 2.24, P=0.002), alpha fetoprotein >100ng/dl (OR 1.18, P 5cm (OR 4.12, P=0.002) and hypervascularity (OR 7.94, P=0.003) were significant effective factors for a local response when analyzed using a multivariate logistic model. Multivariate survival analysis using Cox's regression model during the median follow-up period of 25 months (range: 1-42 months) demonstrated a significant difference in survival rates (P values 5cm and hypervascularity statistically led to a significant effect in tumor response in HCC patients treated with TACE. Patient gender, location of lesion and involvement of portal vein showed no significant difference in response.
经动脉化疗栓塞治疗的肝癌患者慢性肝病相关危险因素的多因素分析
目的:评价慢性肝病(CLD)在肝细胞癌(HCC)患者经动脉化疗栓塞(TACE)相关危险因素的多因素分析中的影响。材料与方法:145例HCC患者(男性99例,女性46例;平均年龄:63岁±8.1岁;年龄范围:46-84岁)598例TACE手术。采用多变量回归模型分析CLD的存在、病变的数量和位置、肿瘤大小、Child-Pugh评分、血管分布、门静脉累及及α胎蛋白值。采用Cox回归进行生存分析。结果:中位生存期为26.7个月,78.6%的治疗病灶出现肿瘤应答。当使用多因素logistic模型分析时,CLD (OR 2.12, P=0.004)、Child-Pugh评分B (OR 2.24, P=0.002)、α胎蛋白>100ng/dl (OR 1.18, P 5cm (OR 4.12, P=0.002)和血管增生(OR 7.94, P=0.003)的存在是局部反应的显著有效因素。采用Cox回归模型进行中位随访25个月(1-42个月)的多因素生存分析,结果显示TACE治疗HCC患者的生存率(P值为5cm)和血管增生在统计学上对肿瘤反应有显著影响。患者性别、病变部位及门静脉受累程度无明显差异。
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