CAJ | 학술논문

目的分析外科治疗巨大肝癌的预后相关因素,提高其综合治疗水平.方法回顾性分析51例经外科治疗的巨大肝癌患者的临床资料.应用Kapla-Meier方法计算生存时间,Cox回归法对15个可能与预后相关的临床病理因素进行统计学分析.结果 50例患者获得随访.术后1、3、5年生存率分别为75.8％、37.9％和21.1％.单因素分析显示术前AFP大于400μg/L、肿瘤大于12 cm、肿瘤边界是否清楚、有无血管侵犯、TNM分期与巨大肝癌的预后有关;Cox多因素回归分析结果显示,有无血管侵犯、肿瘤边界是否清楚、肿瘤大于12 cm是影响巨大肝癌预后的独立因素.单因素分析显示肿瘤边界是否清楚、有无血管侵犯、TNM分期是影响患者复发的重要因素;Cox多因素分析显示血管侵犯是影响患者复发的独立因素.结论外科治疗巨大肝癌相对安全可靠,可改善患者预后.对高危因素患者需要依靠综合治疗以延长生存期.
목적 분석외과치료거대간암적예후상관인소,제고기종합치료수평.방법 회고성분석51례경외과치료적거대간암환자적림상자료.응용Kapla-Meier방법계산생존시간,Cox회귀법대15개가능여예후상관적림상병리인소진행통계학분석.결과 50례환자획득수방.술후1、3、5년생존솔분별위75.8％、37.9％화21.1％.단인소분석현시술전AFP대우400μg/L、종류대우12 cm、종류변계시부청초、유무혈관침범、TNM분기여거대간암적예후유관;Cox다인소회귀분석결과현시,유무혈관침범、종류변계시부청초、종류대우12 cm시영향거대간암예후적독립인소.단인소분석현시종류변계시부청초、유무혈관침범、TNM분기시영향환자복발적중요인소;Cox다인소분석현시혈관침범시영향환자복발적독립인소.결론 외과치료거대간암상대안전가고,가개선환자예후.대고위인소환자수요의고종합치료이연장생존기.
Objective To analyze the prognostic factors for patients who underwent surgical resection for huge liver cancer so as to improve the medical results of comprehensive therapy.Methods We retrospectively arlaysed the data of 51 patients who underwent surgical resection for huge liver cancer.Fifteen clinicopathologic factors possibly influencing survival were selected,and multivariate analysis of these parameters was performed using the Cox proportional hazards model.Survival analysis was done using the KaplanMeier method.Results The overall 1-,3-,5-year survival rates of 50 patients were 75.8％,37.9％ and 21.1％,respectively.Univariate analysis showed that AFP over 400 μg/L,tumor diameter over 12 cm,tumor boundary,vascular invasion and TNM staging significantly affected postoperative survival.Cox multivariate analysis indicated that tumor diameter of ≥ 12 cm,tumor boundary and vascular invasion were independent prognostic factors.Univariate analysis showed that tumor boundary,vascular invasion and TNM staging were the independent factors affecting recurrence,Cox multivariate analysis showed that vascular invasion was an independent factor influencing recurrence of tumor.Conclusions Surgical resection for patients with huge liver cancer could be safely performed with reasonable long-term survival.For patients having tumors with poor prognostic factors,there is a need for effective adjuvant therapy.