Zhou Li-xin, Yan Lu-nan
Department of General Surgery/Liver Transplantation Center, Southwest Hospital, Sichuan University, Chengdu, Sichuan, 610041, P. R. China.
Ai Zheng. 2006 Jun;25(6):736-9.
BACKGROUND & OBJECTIVE: Liver transplantation (LT) is the best treatment for hepatocellular carcinoma (HCC), however, prognostic factors and selection of patients with HCC for LT are controversial. This study was to summarize our experience of LT for HCC, and identify prognostic factors.
The clinical and follow-up data of 98 patients who underwent LT for HCC between Feb. 1999 and Dec. 2004 in our center were analyzed retrospectively. Their survival rates were calculated by Kaplan-Meier method. Log-rank test and Cox proportional hazards regression model were performed to analyze prognostic factors of HCC after LT. All statistical evaluations were performed using SPSS10.0 statistical software.
The follow-up time ranged from 1 to 78 months (median, 37.6 months). The mortality was 31.6%. The recurrence rate was 52.0%. The 1-, 3-, and 5-year survival rates were 84.9%, 49.3%, and 33.2%, respectively. Univariate analysis showed that portal vein tumor thrombus (PVTT), tumor size, serum alpha-fetoprotein (AFP) level, pTNM stage, and histological differentiation were prognostic factors of HCC after LT. Multivariate Cox regression analysis showed that the tumor size and PVTT were independent prognostic factors of HCC after LT.
Tumor size and PVTT are major prognostic factors of HCC after LT.
肝移植（LT）是肝细胞癌（HCC）的最佳治疗方法，然而，HCC患者肝移植的预后因素及患者选择仍存在争议。本研究旨在总结我们中心HCC肝移植的经验，并确定预后因素。
回顾性分析1999年2月至2004年12月在本中心接受HCC肝移植的98例患者的临床及随访资料。采用Kaplan-Meier法计算其生存率。采用Log-rank检验和Cox比例风险回归模型分析肝移植后HCC的预后因素。所有统计评估均使用SPSS10.0统计软件进行。
随访时间为1至78个月（中位数为37.6个月）。死亡率为31.6%。复发率为52.0%。1年、3年和5年生存率分别为84.9%、49.3%和33.2%。单因素分析显示，门静脉癌栓（PVTT）、肿瘤大小、血清甲胎蛋白（AFP）水平、pTNM分期及组织学分化是肝移植后HCC的预后因素。多因素Cox回归分析显示，肿瘤大小和PVTT是肝移植后HCC的独立预后因素。
肿瘤大小和PVTT是肝移植后HCC的主要预后因素。
