原发性肝癌骨转移55例预后分析

Prognostic factors for patients with bone metastasis from primary liver carcinoma：a report of 55 cases

目的：提高对原发性肝癌骨转移的认识及影响预后的相关因素。方法回顾性分析55例原发性肝癌骨转移的诊治方法、疗效及总生存期。结果本组原发性肝癌患者的1、2、3年生存率分别为54．5％、25．5％、16．4％，中位生存期13．0个月；发生骨转移后的1、2、3年生存率分别为23．6％、10．9％、1．8％，中位生存期5．5个月。经单因素和多因素分析，确诊原发性肝癌时是否伴有其他脏器或部位转移、肝功能是否异常、对原发病灶及转移灶是否采取综合治疗是独立的预后因子（ P＜0．05）。骨转移灶的数目、甲胎蛋白的水平及肝内病灶的数目与生存率无明显相关。结论肝癌骨转移的预后相对较差，强调综合治疗的重要性，对缓解症状、提高生活质量及延长生存期均有积极意义。

Objective To improve the clinical diagnosis and prognosis of the treatment of primary liver carcinoma with bone metastasis.Methods A retrospective study on diagnosis and treatment of bone metastasis from 55 cases of primary liver carcinoma was developed.Survival rates were calculated by Kaplan-meier meth-od,univariates analysed by Log-rank and multivariates analysed by Cox regression.Results The 1-,2-and 3-year cumulative survival rates of the cases from primary liver carcinoma were 54.5%,25.5%and 16.4%re-spectively.The mediate survival time was 13 months.And the cases with bone metastasis were 23.6%,10.9%and 1.8%respectively.The mediate survival time was 5.5 months.Factors such as metastasis to other organs,liv-er function,and the combined modality therapy were independent prognostic factors.While number of bone metas-tasis,AFP level and number of liver cancer had no significant relations with the survival rate.Conclusion The prognosis of bone metastasis from primary liver carcinoma is poor.It is important to take emphasis on combined mo-dality therapy,which may be benefit on reducing the symptom,improving the quality and prolong the life span.