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논문 상세정보

간세포암 환자의 간동맥 화학색전술 후의 예후인자 분석

Analysis of Prognostic Factors in Patients with Hepatocellular Carchinoma after Transcatheter Hepatic Arterial Chemoembolization(TAE)

Abstract

Purpose : To evaluate long-term survival rates and prognostic factors of patients with hepatocellular carcinoma after TAE. Materials and Methods : 225 patients with hepatocellular carcinoma treated with TAE between January 1988 and December 1994 were studied. Hepatocellular carcinoma was diagnosed either histologically(n=13) orclinically on the basis of findings characteristic for hepatocellular carcinoma obtained using such as diagnostic imaging methods such as ultrasonography, CT, MRI, and angiography as well as on the basis of high serum alpha-fetoprotein level(n=212). TAE was carried out between one and six times(mean, 1.4 time) using a mixture of lipiodol and Adriamycin, together with Gelfoam. Cumulative survival rates from the day of the first TAE were obtained by the Kaplan-Meier method. Parameters likely to influence the prognosis were subjected to univariate analysis using the log-rank test Results : Cumulative survival rates at the end of the first, second, third, fourth, and fifth year were 55.9%, 32.6%, 21.9%, 17.9%, and 15.0%, respectively. The mean survival time was 727 $\pm$ 76 days. Several factors, including Child-Pugh classification, Okuda's stage, tumor size, presence of portalvein invasion by tumor, of arterio-portal shunt, and of extrahepatic metastases, catheter selection level, and number of TAE showed significant correlation with the outcome. Degrees of Lipiodol accumulation in a tumor on follow up CT were also correlated with survival rates. Conclusion : TAE is an effective measure for prolonging thepatient's life expectancy and evaluation of prognostic factor is helpful for prognosis and in deciding on the optimal therapeutic modality.

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