肝癌术后早期复发的危险因素分析

RISK FACTORS OF EARLY RECURRENCE AFTER HEPATECTOMY FOR HEPATOCELLULAR CARCINOMA

目的肝内复发是影响肝癌术后长期生存的原因之一,本研究探讨影响肝癌术后早期(2年内)复发的危险因素。方法回顾性分析2004年1月—2007年6月在东方肝胆医院行肝切除术的260例肝细胞性肝癌(下称肝癌)患者的临床资料,选择14项临床病理因素分析对无瘤生存率的影响。结果术后1、2年生存率分别为84.1%和70.5%,1、2年无瘤生存率分别为69.2%和58.4%。单因素分析显示肝癌早期复发与下列6个因素有关:术前血清甲胎蛋白、肿瘤大小、肿瘤数目、有无血管癌栓、术中失血量、有无子灶。多因素分析显示术前血清甲胎蛋白、肿瘤大小、有无血管癌栓是术后早期复发的独立危险因素。结论对于肝细胞性肝癌患者,术前血清甲胎蛋白阳性,肿瘤直径≥10.0cm,有血管癌栓,提示术后易早期复发。

Objective Tumor recurrence in liver remnant plays important role in long - term survival after bepatectomy for hepatocellular carcinoma. Thus, the present study was to elucidate the risk factors for early （ within 2 years ） postoperative recurrence of hepatocellular carcinoma. Methods A retrospective analysis was performed.on clinicopathologic data of 260 hepatocellular carcinoma patients who underwent curative hepatectomy in our hospital from Jan 2004 through Jun 2007. 14 parameters contributing to disease- free survival rate were analysed. Results The overall survival rates at 1- and 2- years were 69.2% and 58. 4%, respectively. The following risk factors were present as below： alpha- foetoprotein level, tumor size, tumor number, vascular tumor thrombi, blood loss, satellite nodul were associat- ed with postoperative recurrence. Using multivariate analysis, alpha- foetoprotein level, tumor size, vascular tumor thrombi were significant independent risk factors. Conclusion Our results suggest that patients with positive alphafoetoprotein , tumor size 〉 or = 10 cm and presented vascular tumor thrombi have high risk of developing early recurfence.