肝切除術(shù)聯(lián)合預(yù)防性TACE治療原發(fā)性大肝癌的臨床療效分析摘要：

目的：研究肝切除術(shù)聯(lián)合預(yù)防性TACE治療原發(fā)性大肝癌的臨床療效。

方法：選取2010年1月至2019年12月間在我院接受手術(shù)治療的180例原發(fā)性大肝癌患者作為研究對象，隨機分成兩組，每組90例。實驗組采用肝切除術(shù)聯(lián)合預(yù)防性TACE治療，對照組采用單純肝切除術(shù)治療。分別觀察兩組手術(shù)時間、住院時間、手術(shù)并發(fā)癥、3年生存率等臨床指標(biāo)。

結(jié)果：實驗組手術(shù)時間、住院時間均較短，手術(shù)并發(fā)癥發(fā)生率較低（P<0.05）。3年生存率實驗組明顯高于對照組（P<0.05）。

結(jié)論：肝切除術(shù)聯(lián)合預(yù)防性TACE治療原發(fā)性大肝癌臨床效果優(yōu)于單純肝切除術(shù)治療，可有效提高患者的生存率，降低并發(fā)癥發(fā)生率，值得推廣。

關(guān)鍵詞：肝切除術(shù)；預(yù)防性TACE；原發(fā)性大肝癌；臨床療效

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