肝切除治疗巨大原发性肝癌的预后因素分析

PROGNOSTIC ANALYSIS OF PATIENTS SUFFERING FROM HUGE PRIMARY HEPATIC CARCINOMA AFTER SURGICAL PROCEDURE

目的研究影响巨大原发性肝癌手术切除治疗的预后因素,探讨提高巨大肝癌疗效的途径。方法回顾性分析2001年6月至2008年6月在我院手术治疗的69例巨大原发性肝癌患者的临床资料,用Cox回归分析选择16个对预后可能产生影响的因素进行统计学分析。结果随访到的58例外科手术治疗患者1、3、5年生存率分别为58.2%,31.4%,12.3%;单因素分析结果表明预后影响因素为是否肝内转移、血管侵犯、肝硬化程度和是否根治性切除;多因素分析得出影响巨大肝癌切除术后远期疗效的独立预后因素为肝硬化程度、是否肝内转移和是否根治性切除。结论积极手术切除是治疗巨大肝癌的主要措施,其疗效取决于是否肝内转移、肝硬化程度和是否根治性切除,对术后肝内复发和转移的积极预防和治疗是提高HPLC生存率的主要策略。

Objective To study prognostic factors after surgical procedure for huge primary liver cancer（HPLC）.Methods A retrospective clinical analysis was made in 69 cases of HPLC,admitted to our hospital from July 2001 to July 2008.sixteen clinicopathologic factors that could possibly influence survival were selected.A multivariate analysis of these individuals was performed using the Cox Proportional Hazards Model.Results The accumulative 1-,3-,5-year survival rates of the 58 patients were 58.2%,31.4%,12.3% respectively.Univariate analysis showed that surgical procedure,intrahepatic metastasis,vascular invasion,cirrhosis affected postoperative survival significantly.The Cox multivariate model indicated that independent prognostic factors were surgical procedure,intrahepatic metastasis,cirrhosis.Conclusion Surgical resection is a major treatment of HPLC positively.Intrahepatic metastasis,cirrhosis and radical resection determine their efficacy.Aggressive treatment and prevention on postoperative intrahepatic recurrence metastasis is an important strategy to improve the survival for HPLC.