Park Kyung Woo, Park Joong-Won, Choi Jun Il, Kim Tae Hyun, Kim Seong Hoon, Park Hong Suk, Lee Woo Jin, Park Sang Jae, Hong Eun Kyung, Kim Chang-Min
Center for Liver Cancer, National Cancer Center, Goyang, Republic of Korea.
J Gastroenterol Hepatol. 2008 Mar;23(3):467-73. doi: 10.1111/j.1440-1746.2007.05112.x. Epub 2007 Aug 30.
To investigate the clinical characteristics and survival outcomes of a large cohort of hepatocellular carcinoma (HCC) patients treated at a single institute in a hepatitis B virus (HBV)-endemic area.
Between 2000 and 2003, 904 patients with HCC treated at our institute were enrolled, and followed until 2005.
The mean age of the patients was 56 years and 76.3% were HBV-positive. The 1-, 2-, 3-, and 4-year survival rates were 53.8%, 40.0%, 31.4%, and 25.7%, respectively. The 4-year survival rates for Child-Pugh class A patients treated by resection or transarterial chemoembolization (TACE) were 77.3% and 63.2% for those with modified International Union Against Cancer (UICC) stage I or II disease (P = 0.043), and 58.6% and 19.2% for those with modified UICC stage III disease (P < 0.001). In patients with Child-Pugh class A and stage IVa, the median survival times differed between TACE and chemotherapy treatments (6.9 vs 4.0 months, P = 0.003), whereas in patients with stage IVb there was no difference between treatments (8.5 vs 6.1 months, P = 0.173) Serum alpha-fetoprotein level, presence of portal vein tumor thrombosis, Child-Pugh class, tumor, node, and metastasis stage, and the number and type of HCC were all related to prognosis. Significant differences in survival curves were observed among the Japanese Integrated Staging scores.
The results of this study will be helpful in determining the survival outcomes and treatment strategies for HCC patients in HBV-endemic areas.
调查在乙肝病毒（HBV）流行地区的一家单一机构接受治疗的一大群肝细胞癌（HCC）患者的临床特征和生存结局。
2000年至2003年期间，纳入了在我们机构接受治疗的904例HCC患者，并随访至2005年。
患者的平均年龄为56岁，76.3%为HBV阳性。1年、2年、3年和4年生存率分别为53.8%、40.0%、31.4%和25.7%。对于采用切除或经动脉化疗栓塞（TACE）治疗的Child-Pugh A级患者，国际抗癌联盟（UICC）改良分期I期或II期疾病患者的4年生存率分别为77.3%和63.2%（P = 0.043），而UICC改良分期III期疾病患者的4年生存率分别为58.6%和19.2%（P < 0.001）。在Child-Pugh A级和IVa期患者中，TACE和化疗治疗的中位生存时间存在差异（6.9个月对4.0个月，P = 0.003），而在IVb期患者中，治疗之间没有差异（8.5个月对6.1个月，P = 0.173）血清甲胎蛋白水平、门静脉肿瘤血栓形成的存在、Child-Pugh分级、肿瘤、淋巴结和转移分期以及HCC的数量和类型均与预后相关。在日本综合分期评分之间观察到生存曲线的显著差异。
本研究结果将有助于确定HBV流行地区HCC患者的生存结局和治疗策略。
