HCC切除术后复发是影响患者预后和生存的最重要因素之一，确定了HCC切除术后影响整体生存率和无病生存率的预后因素。这是一个回顾性队列研究设计,选取2005年1月份至2010年12月份的来自嘉泉大学吉尔医学中心的接受肝癌切除术的患者作为受试者。通过对各种临床、实验室、及病理数据进行评估，来确定影响整体生存率和无病生存率的预后因素。 2a和4a整体生存率分别为78.1%、65%，2a和4a无病生存率分别为51.1%、26.6%。在多变量分析中，术前甲胎蛋白（>400毫微克/毫升），肿瘤大小（≥5cm），多发肿瘤（2个或2个以上的结节），门静脉癌栓的存在，修改阶段（UICC）国际癌症控制联盟Ⅲ/Ⅳ期，和巴塞罗那临床肝癌B/ C期是短期内影响整体生存率的独立预后因素。在多变量分析中，存在微血管侵犯，修改阶段（UICC）国际癌症控制联盟Ⅲ/Ⅳ期，巴塞罗那临床肝癌B / C期是短期内影响无病生存期的独立预后因素。存在血管浸润是影响肝癌切除术后整体生存率和无病生存率的一个独立的不良预后因素，因此，迫切要求有血管侵犯的肝癌切除患者，应进行术后密切监测，以便发现早期复发并进行及时治疗。
BACKGROUND/AIMS:
Recurrence after hepatic resection is one of the most important factors impacting the prognosis and survival of patients withhepatocellular carcinoma (HCC). We identified prognostic factors affecting overall survival (OS) and disease-free survival (DFS) in patients with HCCafter hepatic resection.
METHODS:
This study was of a retrospective cohort design, and 126 patients who underwent hepatic resection for HCC at Gachon University Gil Medical Center between January 2005 and December 2010 were enrolled. Various clinical, laboratory, and pathological data were evaluated to determine the prognostic factors affecting OS and DFS.
RESULTS:
Two- and 4-year OS and 2- and 4-year DFS were 78.1% and 65% and 51.1% and 26.6%, respectively. In a multivariate analysis, preoperative α-fetoprotein (> 400 ng/mL), tumor size (≥ 5 cm), multiple tumors (two or more nodules), presence of portal vein invasion, modified Union for International Cancer Control (UICC) stage III/IV, and Barcelona Clinic Liver Cancer (BCLC) stage B/C were independent prognostic factors affecting a shorter OS. In the multivariate analysis, presence of microvascular invasion, modified UICC stage III/IV, and BCLC stage B/C were independent prognostic factors for a shorter DFS.
CONCLUSIONS:
The presence of vascular invasion was an independent poor prognostic factor for OS and DFS in patients with HCC after hepatic resection. Thus, close postoperative surveillance for early detection of recurrence and additional treatments are urgently needed in patients with vascular invasion after hepatic resection.
吉林大学第一医院肝病科 姜红丽 摘译
本文首次发表于[Korean J Intern Med, 2013,28(4):428-38]
本文首次发表于[Korean J Intern Med, 2013,28(4):428-38]
Factors influencing hepatocellular carcinoma prognosis after hepatectomy: a single-center experience.
AbstractBACKGROUND/AIMS:
Recurrence after hepatic resection is one of the most important factors impacting the prognosis and survival of patients withhepatocellular carcinoma (HCC). We identified prognostic factors affecting overall survival (OS) and disease-free survival (DFS) in patients with HCCafter hepatic resection.
METHODS:
This study was of a retrospective cohort design, and 126 patients who underwent hepatic resection for HCC at Gachon University Gil Medical Center between January 2005 and December 2010 were enrolled. Various clinical, laboratory, and pathological data were evaluated to determine the prognostic factors affecting OS and DFS.
RESULTS:
Two- and 4-year OS and 2- and 4-year DFS were 78.1% and 65% and 51.1% and 26.6%, respectively. In a multivariate analysis, preoperative α-fetoprotein (> 400 ng/mL), tumor size (≥ 5 cm), multiple tumors (two or more nodules), presence of portal vein invasion, modified Union for International Cancer Control (UICC) stage III/IV, and Barcelona Clinic Liver Cancer (BCLC) stage B/C were independent prognostic factors affecting a shorter OS. In the multivariate analysis, presence of microvascular invasion, modified UICC stage III/IV, and BCLC stage B/C were independent prognostic factors for a shorter DFS.
CONCLUSIONS:
The presence of vascular invasion was an independent poor prognostic factor for OS and DFS in patients with HCC after hepatic resection. Thus, close postoperative surveillance for early detection of recurrence and additional treatments are urgently needed in patients with vascular invasion after hepatic resection.
