Xu Li, Huang Liang, Li Bin-kui, Zhang Ya-qi, Li Jin-qing, Yuan Yun-fei
State Key Laboratory of Oncology in Southern China and Department of Hepatobiliary Surgery, Sun Yat-sen University Cancer Center, Guangzhou, PR China.
Dig Surg. 2008;25(5):376-82. doi: 10.1159/000170881. Epub 2008 Nov 13.
BACKGROUND/AIMS: Most hepatocellular carcinomas (HCC) are associated with cirrhosis. The clinicopathologic characteristics and outcomes of HCC present in non-cirrhotic livers are not well known in Chinese patients. This study was performed to explore the features of these patients and their outcomes after hepatectomy.
96 patients with histologically confirmed HCC in non-cirrhotic liver who underwent partial hepatectomy between 1995 and 2001 in our cancer center were reviewed. A retrospective analysis of the clinicopathologic features was performed, and survival of patients was analyzed by the Kaplan-Meier method and Cox regression model.
Operative mortality and morbidity were none and 8.3% (8/96), respectively. Postoperative overall survival (OS) rates at 1, 3, 5 and 10 years were 84.4, 62.5, 47.9 and 38.2%, respectively, with a median OS of 57 months. Disease-free survival (DFS) rates at 1, 3, and 5 years were 56.3, 39.6, and 33.3%, respectively, with a median DFS of 18 months. TNM stage was an independent prognostic factor for both OS and DFS of non-cirrhotic HCC. Operative blood loss was an independent prognostic factor for OS and DFS of patients who received curative resection.
Curative partial hepatectomy was an effective and safe treatment for non-cirrhotic HCC. Aggressive local therapies were recommended for patients with intrahepatic recurrence.
背景/目的:大多数肝细胞癌(HCC)与肝硬化相关。在中国患者中,非肝硬化肝脏中HCC的临床病理特征及预后尚不明确。本研究旨在探讨这些患者的特征及其肝切除术后的预后。
回顾性分析1995年至2001年在我院癌症中心接受部分肝切除术的96例经组织学确诊的非肝硬化肝脏HCC患者。对其临床病理特征进行回顾性分析,并采用Kaplan-Meier法和Cox回归模型分析患者的生存率。
手术死亡率为0,手术并发症发生率为8.3%(8/96)。术后1年、3年、5年和10年的总生存率(OS)分别为84.4%、62.5%、47.9%和38.2%,中位OS为57个月。无病生存率(DFS)1年、3年和5年分别为56.3%、39.6%和33.3%,中位DFS为18个月。TNM分期是影响非肝硬化HCC患者OS和DFS的独立预后因素。手术出血量是接受根治性切除患者OS和DFS的独立预后因素。
根治性部分肝切除术是治疗非肝硬化HCC的一种有效且安全的方法。对于肝内复发患者,建议采取积极的局部治疗。