CAJ | 학술논문

目的分析了解巴塞罗那分期0-A期肝细胞肝癌复发因素.方法回顾性分析2006年12月1日至2013年7月30日间中国医学科学院肿瘤医院同一治疗团队进行外科治疗的218例巴塞罗那分期0-A期肝细胞肝癌患者的临床资料,应用Kaplan-Meier方法计算生存时间,Cox回归法对17个可能与复发及预后相关的临床病理因素进行统计学分析.结果 218例患者全部获得随访,术后1、3、5年总生存率分别为95.9％、85.3％和67.6％,中位生存期35.0个月.1、3、5年无病生存率为84.4％、56.5％、47.0％,中位无复发生存期25个月.单因素分析显示合并肝硬化、甲胎蛋白(AFP)阳性、卫星病灶、肿瘤累及肝被膜、肿瘤分化、脉管瘤栓与患者复发有关,Cox多因素分析显示卫星结节、脉管瘤栓、肿瘤累及肝被膜是患者复发的独立因素.结论外科治疗是巴塞罗那分期0-A期肝细胞肝癌的首选,卫星结节、脉管瘤栓、肿瘤累及肝被膜是患者复发的独立因素,对于有复发危险因素的患者术后行介入治疗不能延长患者生存时间.
목적 분석료해파새라나분기0-A기간세포간암복발인소.방법 회고성분석2006년12월1일지2013년7월30일간중국의학과학원종류의원동일치료단대진행외과치료적218례파새라나분기0-A기간세포간암환자적림상자료,응용Kaplan-Meier방법계산생존시간,Cox회귀법대17개가능여복발급예후상관적림상병리인소진행통계학분석.결과 218례환자전부획득수방,술후1、3、5년총생존솔분별위95.9％、85.3％화67.6％,중위생존기35.0개월.1、3、5년무병생존솔위84.4％、56.5％、47.0％,중위무복발생존기25개월.단인소분석현시합병간경화、갑태단백(AFP)양성、위성병조、종류루급간피막、종류분화、맥관류전여환자복발유관,Cox다인소분석현시위성결절、맥관류전、종류루급간피막시환자복발적독립인소.결론 외과치료시파새라나분기0-A기간세포간암적수선,위성결절、맥관류전、종류루급간피막시환자복발적독립인소,대우유복발위험인소적환자술후행개입치료불능연장환자생존시간.
Objecfive To analyze the risk factors of recurrence in patients with Barcelona Clinic Liver Cancer (BCLC) 0-A hepatocellular carcinoma (HCC) after surgical resection.Methods Retrospective analyses were conducted for 218 patients undergoing surgical resection for BCLC 0-A HCC.A total of 17 clinicopathologic factors possibly influencing the recurrence and survival were selected.And multivariate analysis of these parameters was performed with Cox proportional hazard model.Survival analysis was performed with the Kaplan-Meier method.Results The overall 1,3,5-year survival rates were 95.9％,85.3％ and 67.6％ respectively.The median survival from time of primary resection was 35 months.The overall 1,3 and 5-year disease-free survival (DFS) rates were 84.4％,56.5％ and 47.0％ respectively.Univariate analysis showed that cirrhosis,positive alpha-fetoprotein (AFP),satellite nodules,involvement of hepatic capsule,tumor differentiation and microvascular invasion were associated with recurrence.And Cox multivariate analysis showed that satellite nodules,involvement of hepatic capsule and microvascular invasion were the independent risk factors for recurrence.Conclusion Surgical resection is a first option for BCLC 0-A HCC.Satellite nodules,involvement of hepatic capsule and microvascular invasion are independent risk factors for recurrence.Postoperative transarterial chemoembolization does not benefit the survival of patients with risk factors of recurrence.