目的:本研究旨在使用“六和十二”预后评分评估符合经动脉化疗栓塞(TACE)的肝细胞癌患者的总体生存率。该研究是在2009年至2019年期间对患者队列进行的。
方法:进行了一项回顾性队列研究,包括诊断为不可切除的肝癌的患者,巴塞罗那诊所肝癌(BCLC)分期A或B,Child-Pugh分期A或B。排除标准包括自发性肿瘤破裂患者,其他肿瘤,失代偿期肝硬化,缺乏参考图像。该研究根据影像学研究评估了最大结节的大小和肿瘤的数量。总生存期定义为从初始TACE到任何原因死亡的时间,进行电话跟进。根据肿瘤负荷将患者分为三组:≤6、>6-≤12和>12。12、24和36个月的死亡率比较了分类变量的卡方检验和连续变量的ANOVA和Kruskal-Wallis检验。取决于他们的分布。
结果:本研究共纳入90例患者,年龄中位数为69岁(四分位数间距(IQR):62-77)。在患者中,61.1%的肿瘤负荷为6或更低。总生存率中位数为28.4个月(IQR:26.3-30.5),存活率为1,两个,三年为84.7%,55.2%,和29.4%,分别。观察到死亡率与肿瘤负担成比例增加,这种差异具有统计学意义。
结论:使用肿瘤负荷,截止点为6和12,作为预后评分被证明是预测研究队列死亡率的有价值的工具.
OBJECTIVE: This study aimed to evaluate the overall survival of hepatocellular carcinoma patients who qualify for transarterial chemoembolization (TACE) using the \"six-and-twelve\" prognostic score. The research was conducted on a patient cohort between 2009 and 2019.
METHODS: A retrospective cohort study was conducted, involving patients diagnosed with unresectable hepatocarcinoma, Barcelona Clinic Liver Cancer (BCLC) staging A or B, and Child-Pugh staging A or B. Exclusion criteria included patients with spontaneous tumor rupture, other neoplasms, decompensated liver cirrhosis, and a lack of reference images. The study assessed the size of the largest nodule and the number of tumors based on imaging studies. Overall survival was defined as the time from initial TACE to death from any cause, with telephonic follow-up conducted. Patients were categorized into three groups based on tumor burden: ≤6, >6-≤12, and >12. Mortality rates at 12, 24, and 36 months were compared using the chi-square test for categorical variables and the ANOVA and Kruskal-Wallis tests for continuous variables, depending on their distribution.
RESULTS: A total of 90 patients were included in the study, with a median age of 69 years (interquartile range (IQR): 62-77). Among the patients, 61.1% had a tumor burden of six or less. The overall survival rate was found to have a median of 28.4 months (IQR: 26.3-30.5), with survival rates at one, two, and three years being 84.7%, 55.2%, and 29.4%, respectively. It was observed that mortality increased in proportion to tumor burden, and this difference was statistically significant.
CONCLUSIONS: The use of tumor burden, with cut-off points of six and 12, as a prognostic score proved to be a valuable tool for predicting mortality in the studied cohort.