符合米兰标准的早期肝癌患者肝切除术后生存分析
부합미란표준적조기간암환자간절제술후생존분석
A survival analysis of patients with early-stage hepatocellular carcinoma fulfilling Milan criteria and undergoing hepatectomy
  • 万方数据
    中华医学杂志 중화의학잡지
    National Medical Journal of China
    2010年 46期 3251-3254 ,共4页

    刘立国%缪若羽%卢欣%徐意瑶%杜顺达%徐海峰%迟天毅%杨华瑜%杨志英%毛一雷%桑新亭%钟守先%黄洁夫%赵海涛

    류입국%무약우%로흔%서의요%두순체%서해봉%지천의%양화유%양지영%모일뢰%상신정%종수선%황길부%조해도

    肝肿瘤%肝切除术%预后 肝腫瘤%肝切除術%預後
    간종류%간절제술%예후
    Liver neoplasms%Hepatectomy%Prognosis
    目的 总结符合米兰标准的肝癌患者肝切除术经验,探讨影响术后生存和复发生存的临床及病理因素.方法 回顾性分析北京协和医院2003年4月至2009年6月期间收治的104例符合米兰标准并经手术切除的早期肝癌患者的临床及病理资料.结果 中位随访时间24个月,54例复发,1、3、5年累积无复发生存率分别为63.0%,32.6%和22.4%,复发组与无复发组之间临床病理参数差异无统计学意义,单因素及多因素分析均未提示与复发显著相关的因素(P＞0.05).1、3、5年累积生存率分别为88.8%,68.1%和68.1%,单因素分析显示输血(P=0.000)、累及肝被膜(P=0.000)、术后介入治疗(P=0.049)与生存显著相关;多因素分析则显示输血(P=0.001)和累及肝被膜(P=0.000)是影响生存的独立预后因素.结论 对于符合米兰标准且肝功能处于代偿期的早期肝癌患者,在治疗策略上可以将肝切除作为首选治疗方案.
    목적 총결부합미란표준적간암환자간절제술경험,탐토영향술후생존화복발생존적림상급병리인소.방법 회고성분석북경협화의원2003년4월지2009년6월기간수치적104례부합미란표준병경수술절제적조기간암환자적림상급병리자료.결과 중위수방시간24개월,54례복발,1、3、5년루적무복발생존솔분별위63.0%,32.6%화22.4%,복발조여무복발조지간림상병리삼수차이무통계학의의,단인소급다인소분석균미제시여복발현저상관적인소(P＞0.05).1、3、5년루적생존솔분별위88.8%,68.1%화68.1%,단인소분석현시수혈(P=0.000)、루급간피막(P=0.000)、술후개입치료(P=0.049)여생존현저상관;다인소분석칙현시수혈(P=0.001)화루급간피막(P=0.000)시영향생존적독립예후인소.결론 대우부합미란표준차간공능처우대상기적조기간암환자,재치료책략상가이장간절제작위수선치료방안.
    Objective To summarize the experience of hepatectomy in patients with hepatocellular carcinoma fulfilling the Milan criteria and analyze the clinicopathological factors for patient survival and tumor recurrence. Methods The clinicopathological data of 104 patients with early-stage hepatocellular carcinoma fulfilling the Milan criteria and underwent hepatectomy at Peking Union Medical College Hospital between April 2003 and June 2009 were retrospectively analyzed. Results The median follow-up was 24 months. There were 54 recurrent cases. The 1-, 3- and 5-year cumulative disease-free survival rate were 63.0%, 32. 6% and 22. 4% respectively. Neither univariate analysis nor multivariate analysis indicated any factor significantly correlated with recurrence ( P ＞0. 05). The cumulative overall survival rate at 1,3 and 5 years were 88. 8%, 68. 1% and 68. 1% respectively. Univariate analysis revealed that blood transfusion (P = 0. 000), involvement of hepatic capsule ( P = 0. 000 ) and postoperative transarterial chemotherapy (P =0. 049) were significantly correlated with survival And multivariate analysis indicated that blood transfusion (P = 0. 001 ) and involvement of hepatic capsule (P = 0. 000) were independent prognostic factors for survival. Conclusion For the patients with early-stage hepatocellular carcinoma and compensated liver function fulfilling the Milan criteria, hepatectomy serves as the preferred treatment strategy.
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