CAJ | 학술논문

目的用Cox模型多因素分析再手术切除治疗复发性肝癌的疗效,探讨其预后影响因素.方法 1995年1月-2010年12月收集60例复发性肝癌行再手术切除的患者资料,分析其疗效并收集17项可能影响预后的临床及病理因素作回顾性单因素(Kaplan-Meier Log-rank test)与多因素分析(Cox模型),得出其生存预后影响因素.结果全组患者1、3、5年生存率分别是76.3%、40.7%、25.0%(从再切除术后算起)和95.0%、62.6%、43.3%(从初次手术算起);单因素分析显示初次肿瘤大小、复发期限长短、血清ALB水平、手术切缘、复发肿瘤最大径、血管侵犯与复发性肝癌再手术切除预后差异有统计学意义(P<0.05);进一步行Cox模型多因素分析得出与预后有关因素为:复发期限长短、手术切缘、复发肿瘤最大径与血管侵犯(P<0.05).结论再手术切除治疗复发性肝癌疗效确切,复发期限长短、手术切缘、复发肿瘤最大径与血管侵犯为其显著性预后影响因子.
목적 용Cox모형다인소분석재수술절제치료복발성간암적료효,탐토기예후영향인소.방법 1995년1월-2010년12월수집60례복발성간암행재수술절제적환자자료,분석기료효병수집17항가능영향예후적림상급병리인소작회고성단인소(Kaplan-Meier Log-rank test)여다인소분석(Cox모형),득출기생존예후영향인소.결과 전조환자1、3、5년생존솔분별시76.3%、40.7%、25.0%(종재절제술후산기)화95.0%、62.6%、43.3%(종초차수술산기);단인소분석현시초차종류대소、복발기한장단、혈청ALB수평、수술절연、복발종류최대경、혈관침범여복발성간암재수술절제예후차이유통계학의의(P<0.05);진일보행Cox모형다인소분석득출여예후유관인소위:복발기한장단、수술절연、복발종류최대경여혈관침범(P<0.05).결론 재수술절제치료복발성간암료효학절,복발기한장단、수술절연、복발종류최대경여혈관침범위기현저성예후영향인자.
Objective This retrospective study was to explore the efficacy and determine the risk factors of survival for recurrent hepatocellular carcinoma ( HCC) treated by repeat hepatectomy. Methods From January 1995 till December 2010, 60 patients with recurrent HCCs, were treated by repeat hepatectomy.The significance of seventeen clinical or pathological variables in the risk factors of overall survival were assessed. Results The overall survival 1,3, and 5-year survival rates were 76. 3% , 40.7% and 25. 0% (from repeat hepatectomy), and 95. 0% , 62. 6% and 43. 3% ( from initial hepatectomy) , respectively.Univariate analysis indicated that tumor size at initial hepatectomy, recurrence interval from initial hepatectomy, serum albumin(ALB) level, resection margin, diameter of largest recurrence tumor and rumor vascular invasion were significant prognostic factors(P <0. 05, Kaplan-Meier Log-rank test). Multivariate analysis showed recurrence interval from initial hepatectomy, resection margin, diameter of largest recurrence tumor and rumor vascular invasion were significant prognostic factors(P<0.05, Cox proportional hazards model).Conclusion Repeat hepatectomy is effective for recurrent HCC. Recurrence interval from initial hepatectomy, resection margin, diameter of largest recurrence tumor and rumor vascular invasion were significant prognostic factors.