Objective To validate the predictive power of the 5th and 6th editions of TNM staging system(TNM-5,TNM-6) in a Chinese patient cohort with hepatocellular carcinoma(HCC) sized > or = 5 cm after radical hepatectomy.M...Objective To validate the predictive power of the 5th and 6th editions of TNM staging system(TNM-5,TNM-6) in a Chinese patient cohort with hepatocellular carcinoma(HCC) sized > or = 5 cm after radical hepatectomy.Methods Consecutive 121 patients with HCC sized > or = 5 cm undergoing radical hepatectomy between January 1995 and December 2002 were included.The impact of clinicopathological variables on prognosis was determined by univariate and multivariate analyses,after excluding 2 perioperative deaths.Results In univariate analysis,TNM-5 stage did not show prognostic significance for overall or disease-free survival,as opposed to TNM-6 stage,Edmondson-Steiner grade,portal vein tumor thrombosis(PVTT),vascular invasion,satellite nodule,Child-Pugh grade,and hepatitis B surface antigen(HBsAg) positivity.When these significant variables were entered in multivariate analysis,Edmondson-Steiner grade was the sole independent prognosticator for both overall and disease-free survival,whereas Child-Pugh grade independently influenced disease-free survival.However,TNM-6 stage lost its predictive potential in multivariate analysis.Conclusions Neither TNM-5 nor TNM-6 staging system is revealed to be independently prognostic in patients with HCC sized > or = 5 cm after radical hepatectomy.Therefore,TNM-6 calls for more support in many subsets of HCC patients.展开更多
基金Supported by the Grant for Municipal Key Disciplines of Beijing,China (HK100230446)
文摘Objective To validate the predictive power of the 5th and 6th editions of TNM staging system(TNM-5,TNM-6) in a Chinese patient cohort with hepatocellular carcinoma(HCC) sized > or = 5 cm after radical hepatectomy.Methods Consecutive 121 patients with HCC sized > or = 5 cm undergoing radical hepatectomy between January 1995 and December 2002 were included.The impact of clinicopathological variables on prognosis was determined by univariate and multivariate analyses,after excluding 2 perioperative deaths.Results In univariate analysis,TNM-5 stage did not show prognostic significance for overall or disease-free survival,as opposed to TNM-6 stage,Edmondson-Steiner grade,portal vein tumor thrombosis(PVTT),vascular invasion,satellite nodule,Child-Pugh grade,and hepatitis B surface antigen(HBsAg) positivity.When these significant variables were entered in multivariate analysis,Edmondson-Steiner grade was the sole independent prognosticator for both overall and disease-free survival,whereas Child-Pugh grade independently influenced disease-free survival.However,TNM-6 stage lost its predictive potential in multivariate analysis.Conclusions Neither TNM-5 nor TNM-6 staging system is revealed to be independently prognostic in patients with HCC sized > or = 5 cm after radical hepatectomy.Therefore,TNM-6 calls for more support in many subsets of HCC patients.
