92例晚期肝细胞癌患者肝切除预后及危险因素分析

Prognosis and survival risk factors for 92 advanced hepatocellular carcinoma patients after hepatectomy

目的:探讨行肝切除术的晚期肝细胞癌患者的预后及影响生存的危险因素。方法:回顾性分析2007年6月-2013年12月在天津医科大学肿瘤医院行肝切除的92例晚期肝癌患者的临床资料,使用K-M法及Log-rank分析筛选可能影响患者预后的相关因素,使用COX回归检验模型明确影响预后的独立危险因素。结果:患者总体的中位生存时间为27.1个月,年龄<60岁(P=0.001)、AFP≥400 ng/mL(P=0.037)、微血管侵犯(P=0.007)、肝大部切除(P=0.001)为影响患者术后生存的独立危险因素。总体无复发生存时间为13.5个月,AFP≥400 ng/mL(P=0.017)为影响患者术后复发的独立危险因素。结论:部分晚期肝癌患者经肝切除治疗可获得良好的预后。

Objective： To analyze prognosis and survival risk factors for advanced hepatocellular carcinoma （HCC） patients treated by surgery． Methods： Clinical data of 92 patients from Tianjin Medical University Cancer Institute Hospital who underwent surgery from June 2007 to December 2013 were retrospectively studied． Kaplan-Meier method and log-rank test were used to discover potential prognostic factors. The COX proportional hazards models were applied to identify the independent risk factors for survival and disease-free survival. Results： The median overall survival was 27.1 months. Age＜60 year（P=0.001），AFP≥400 ng/mL（P =0.037），microvessel invasion（P =0.007） and major hepatectomy （P =0.001） were the independent risk factors for overall survival. The median disease-free survival was 13.5 months. AFP≥400 ng/mL（P =0.017） was the independent risk factor for recurrence. Conclusion： Some patients with advanced liver cancer can get a better prognosis after liver resection.