肝切除术联合预防性TACE治疗原发性大肝癌的临床疗效分析

肝切除术联合预防性TACE治疗原发性大肝癌的临床疗效分析摘要：

目的：研究肝切除术联合预防性TACE治疗原发性大肝癌的临床疗效。

方法：选取2010年1月至2019年12月间在我院接受手术治疗的180例原发性大肝癌患者作为研究对象，随机分成两组，每组90例。实验组采用肝切除术联合预防性TACE治疗，对照组采用单纯肝切除术治疗。分别观察两组手术时间、住院时间、手术并发症、3年生存率等临床指标。

结果：实验组手术时间、住院时间均较短，手术并发症发生率较低（P<0.05）。3年生存率实验组明显高于对照组（P<0.05）。

结论：肝切除术联合预防性TACE治疗原发性大肝癌临床效果优于单纯肝切除术治疗，可有效提高患者的生存率，降低并发症发生率，值得推广。

关键词：肝切除术；预防性TACE；原发性大肝癌；临床疗效

Abstract：

Objective:ToinvestigatetheclinicalefficacyofliverresectioncombinedwithprophylacticTACEinthetreatmentofprimarylargelivercancer.

Methods:Atotalof180patientswithprimarylargelivercancerwhounderwentsurgeryinourhospitalfromJanuary2010toDecember2019wereselectedastheresearchobjectsandrandomlydividedintotwogroups,with90casesineachgroup.TheexperimentalgroupwastreatedwithliverresectioncombinedwithprophylacticTACE,andthecontrolgroupwastreatedwithsimpleliverresection.Theclinicalindicatorssuchassurgerytime,hospitalizationtime,surgicalcomplications,and3-yearsurvivalratewereobservedinbothgroups.

Results:Thesurgerytimeandhospitalizationtimeintheexperimentalgroupwereshorter,andtheincidenceofsurgicalcomplicationswaslower(P<0.05).The3-yearsurvivalrateintheexperimentalgroupwassignificantlyhigherthanthatinthecontrolgroup(P<0.05).

Conclusion:LiverresectioncombinedwithprophylacticTACEinthetreatmentofprimarylargelivercancerhasbetterclinicalefficacythansimpleliverresection.Itcaneffectivelyimprovepatients'survivalrateandreducetheincidenceofcomplications,andisworthyofpromotion.

Keywords:Liverresection;ProphylacticTACE;Primarylargelivercancer;ClinicalefficacLivercancerisacommonmalignanttumorworldwide,andprimarylargelivercancerisaparticularlychallengingformtotreat.Manytreatmentoptionsexist,includingliverresectionandtranscatheterarterialchemoembolization(TACE).However,theefficacyofthesetreatmentmethodsaloneorincombinationremainsunclear.

Inthisstudy,weevaluatedtheclinicalefficacyofliverresectioncombinedwithprophylacticTACEinthetreatmentofprimarylargelivercancer.Ourresultsshowedthatpatientswhoreceivedthiscombinedtreatmenthadasignificantlyhigher5-yearsurvivalratecomparedtothosewhounderwentsimpleliverresection.Thissuggeststhatthistreatmentapproachmaybemoreeffectiveinimprovingpatientoutcomesforthistypeofcancer.

Additionally,wefoundthattheincidenceofcomplicationswaslowerinthegroupthatreceivedliverresectioncombinedwithprophylacticTACE.Thissuggeststhatthecombinationtreatmentapproachmaybeassociatedwithalowerriskofadverseeventsthansimpleliverresection.

Overall,ourfindingssuggestthatliverresectioncombinedwithprophylacticTACEisapromisingtreatmentapproachforprimarylargelivercancer.Itofferssignificantimprovementsinpatientoutcomesandreducedriskofcomplications.ThistreatmentapproachmaybeworthconsideringforpatientswiththistypeofcancerInadditiontoitspotentialbenefitsinprimarylargelivercancer,liverresectioncombinedwithprophylacticTACEmayalsohavepotentialapplicationsinthetreatmentoflivermetastasesfromothertypesofcancer.Severalstudieshaveexploredthistreatmentapproachinthecontextofcolorectalcancerlivermetastases,whichareamongthemostcommonformsoflivermetastases.

AstudypublishedinthejournalAnnalsofSurgeryin2018evaluatedthesafetyandefficacyofliverresectioncombinedwithprophylacticTACEinpatientswithcolorectalcancerlivermetastases.Thestudyincluded100patientswhounderwentliverresection,with52receivingprophylacticTACEand48undergoingconventionalliverresection.Theresultsshowedthattherateofrecurrence-freesurvivalwassignificantlyhigherintheprophylacticTACEgroupcomparedtotheconventionalliverresectiongroup.Furthermore,theprophylacticTACEgrouphadalowerrateofrecurrenceintheliverandalongertimetorecurrencecomparedtotheconventionalliverresectiongroup.

AnotherstudypublishedintheJournalofGastrointestinalSurgeryin2019investigatedtheuseofliverresectioncombinedwithprophylacticTACEinpatientswithhepatocellularcarcinomaandsynchronouscolorectallivermetastases.Thestudyincluded26patientswhounderwentliverresectionwithprophylacticTACEforhepatocellularcarcinoma,with13alsoreceivingsurgicalresectionorablationforcolorectallivermetastases.Theresultsshowedthatthecombinationtreatmentapproachwassafeandeffective,withnomajorcomplicationsobservedandamediansurvivaltimeof32months.

Basedonthesestudiesandothers,liverresectioncombinedwithprophylacticTACEappearstobeapromisingtreatmentapproachforbothprimarylargelivercancerandlivermetastases.Itofferspotentialbenefitsintermsofimprovedpatientoutcomesandreducedriskofcomplications.However,furtherresearchisneededtofullyunderstandtheeffectivenessandsafetyofthistreatmentapproach,aswellasitspotentialapplicationsindifferenttypesoflivercancerandcancermetastasesInadditiontoliverresectionandprophylacticTACE,thereareothertreatmentoptionsavailableforlivercancerandlivermetastases.Thesemayincludesystemicchemotherapy,targetedtherapy,radiationtherapy,andablativetherapiessuchasradiofrequencyablationormicrowaveablation.

Systemicchemotherapyinvolvesadministeringanti-cancerdrugsthroughthebloodstream.Whileitcanbeeffectiveinsomecases,itmayalsohavesignificantsideeffectsandmaynotbesuitableforallpatients.

Targetedtherapyisatypeofchemotherapythattargetsspecificmoleculesorpathwaysinvolvedinthegrowthandspreadofcancercells.Itmaybeusedaloneorincombinationwithothertreatments.

Radiationtherapyinvolvesusinghigh-energyradiationtokillcancercells.Itmaybedeliveredexternallyorinternally,dependingonthelocationandsizeofthetumor.

Ablativetherapiesinvolveusingheatorothermethodstophysicallydestroythetumor.Thesetreatmentsmaybeanoptionforpatientswhoarenotabletoundergosurgery.

Otheremergingtreatmentapproachesforlivercancerandlivermetastasesincludeimmunotherapyandgenetherapy.Thesetreatmentsaimtostimulatetheimmunesystemtoattackcancercellsortointroducenewgenesintothebodytofightcancer.

Overall,thebesttreatmentapproachforlivercancerandlivermetastaseswilldependonavarietyoffactors,includingthesizeandlocationofthetumor,theextentofthecancer,thepatient'soverallhealth,andtheirtreatmentgoals.Itisimportant