BCLC B期肝细胞癌的外科疗效及预后危险因素

SURGICAL EFFICACY AND PROGNOSTIC RISK FACTORS FOR STAGE B HEPATOCELLULAR CARCINOMA IN THE BARCELONA CLINIC LIVER CANCER CLASSIFICATION

目的探讨手术治疗BCLC B期肝细胞癌的疗效及预后危险因素。方法分析东方肝胆医院1996年至2001年共545例肝癌的临床病理资料,随访终点为2008年9月1日,以复发或死亡作为终点事件。对其外科治疗的复发率、生存率及预后相关危险因素进行分析总结。结果545例肝癌中,1、3、5、10年复发率为9.7%、40.9%、58.6%、64.0%,相应的总体生存率为80.5%、50.7%、41.1%、27.4%。结论BCLC B期肝癌患者术后经多因素分析,AFP≥400 ng/mL、肿瘤直径≥10cm、肿瘤数目>3、切缘<2 cm、包膜不完整是影响其手术预后的独立危险因素。该期病人经严格的术前评估和规范的手术操作,亦可达到较好的疗效。

Objective To evaluate the surgical treatment of BCLC B period of the efficacy and prognosis of hepatoeellular carcinoma risk factors. Methods From 1996 to 2001,545 patients underwent hepatectomy for HCC in our hospital were enrolled for summarizing their Clinicopathological records. Follow up to September 2008, recurrence or death of patients is considered as the endpoint. Their recurrence rate, survival rate and prognostic risk factors of surgical treatments were analyzed and summarized. Results The 1-, 3-,5-, 10-year recurrence rates were 9. 7% ,40. 9% ,58. 6% ,64. 0%, and the corresponding overall survival rates were 80. 5%, 50. 7% ,41.1%, 27.4%, respectively. Conclusions Multivariate Cox regression analysis showed that AFP, tumor diameter, tumor number, surgical margin, capsule were independent risk factors of prognosis. After strict preoperative evaluation and standardized surgical operation, the patients with BCLC stage B HCC can achieve good efficacy.