目的 评估外科手术治疗肝细胞癌(HCC)伴肝静脉癌栓(HVTT)的疗效及随访结果。方法 回顾性队列研究2015年4月至2017年4月就诊于本院的65例HCC伴HVTT患者临床资料,将接受外科手术治疗的31例患者纳入外科组,将实施经导管肝动脉化疗栓塞术(TACE)的34例患者纳入TACE组。采用SPSS24.0软件进行处理,肝癌患者生存质量测定量表(QOL-LC V2.0)评分以(`χ±S)表示,独立t检验；疗效、并发症、生存率用百分比表示,用χ_²检验,采用生存函数Kaplan-meier计算生存率,P＜0.05为差异有统计学意义。结果 外科组ORR(51.6%)略高于TACE组(32.4%),但差异无统计学意义(P＞0.05)；外科组DCR(77.4%)比TACE组(52.9%)高(P＜0.05)；术后1年外科组QOL-LC V2.0量表各维度评分及总分均比TACE组高(P＜0.05)；外科组术后并发症发生率(7.0%)略低于TACE(14.7%),但差异无统计学意义(P＞0.05)；外科组术后1年生存率(74.2%)比TACE(50.0%)高(P＜0.05)；外科组术后2、3年生存率(45.2%、25.8%)相比TACE组(32.4%、14.7%),但差异无统计学意义(P＞0.05)。结论 外科手术、TACE均可有效治疗HCC伴HVTT,且术后并发症少,但外科手术更利于改善患者生活质量、提高术后生存率,远期预后好。

【Abstract】Objective evaluate the efficacy and follow-up of surgical treatment for Hepatocellular Carcinoma (HCC) with hepatic vein tumor Thrombus (Hvtt) .Methods A retrospective cohort study of clinical data of 65 patients with HCC and HVTT who visited our hospital from April 2015 to April 2017, 31 patients undergoing surgical treatment were included in the surgical group, and transcatheter arterial chemoembolization will be performed. (TACE) 34 patients were included in the TACE group.SPSS2 4.0 software was used for processing, and the score of quality of life measurement scale for liver cancer patients (QOL-LC V2.0) was expressed as (`χ ± S), independent t test; efficacy, complications, and survival rate were expressed as percentages, χ2 test, using the survival function Kaplan-meier to calculate the survival rate, P<0.05 was considered statistically significant.Results ORR (51.6%) in the surgical group was slightly higher than that in the TACE group (32.4%), but the difference was not statistically significant (P> 0.05); DCR (77.4%) in the surgical group was higher than that in the TACE group (52.9%) (P <0.05) The score and total score of the QOL-LC V2.0 scale in the surgical group at 1 year after surgery are higher than those in the TACE group (P <0.05); The incidence of postoperative complications (7.0%) in the surgical group is slightly lower than TACE (14.7 %), But the difference was not statistically significant (P> 0.05); 1-year survival rate (74.2%) in the surgical group was higher than TACE (50.0%) (P <0.05); 2-year and 3-year survival rate in the surgical group (45.2%, 25.8%) Compared with TACE group (32.4%, 14.7%), but the difference was not statistically significant (P> 0.05).Conclusion Surgery and TACE can effectively treat HCC with HVTT, and there are few postoperative complications, but surgery is more conducive to improving the patient''s quality of life, postoperative survival rate, and long-term prognosis.