Liu Li-guo, Miao Ruo-yu, Lu Xin, Xu Yi-yao, Du Shun-da, Xu Hai-feng, Chi Tian-yi, Yang Hua-yu, Yang Zhi-ying, Mao Yi-lei, Sang Xin-ting, Zhong Shou-xian, Huang Jie-fu, Zhao Hai-tao
Department of Hepatic Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China.
Zhonghua Yi Xue Za Zhi. 2010 Dec 14;90(46):3251-4.
To summarize the experience of hepatectomy in patients with hepatocellular carcinoma fulfilling the Milan criteria and analyze the clinicopathological factors for patient survival and tumor recurrence.
The clinicopathological data of 104 patients with early-stage hepatocellular carcinoma fulfilling the Milan criteria and underwent hepatectomy at Peking Union Medical College Hospital between April 2003 and June 2009 were retrospectively analyzed.
The median follow-up was 24 months. There were 54 recurrent cases. The 1-, 3- and 5-year cumulative disease-free survival rate were 63.0%, 32.6% and 22.4% respectively. Neither univariate analysis nor multivariate analysis indicated any factor significantly correlated with recurrence (P>0.05). The cumulative overall survival rate at 1, 3 and 5 years were 88.8%, 68.1% and 68.1% respectively. Univariate analysis revealed that blood transfusion (P=0.000), involvement of hepatic capsule (P=0.000) and postoperative transarterial chemotherapy (P=0.049) were significantly correlated with survival. And multivariate analysis indicated that blood transfusion (P=0.001) and involvement of hepatic capsule (P=0.000) were independent prognostic factors for survival.
For the patients with early-stage hepatocellular carcinoma and compensated liver function fulfilling the Milan criteria, hepatectomy serves as the preferred treatment strategy.
总结符合米兰标准的肝细胞癌患者肝切除术的经验，并分析影响患者生存及肿瘤复发的临床病理因素。
回顾性分析2003年4月至2009年6月在北京协和医院接受肝切除术的104例符合米兰标准的早期肝细胞癌患者的临床病理资料。
中位随访时间为24个月。有54例复发病例。1年、3年和5年累积无病生存率分别为63.0%、32.6%和22.4%。单因素分析和多因素分析均未显示有任何因素与复发显著相关（P>0.05）。1年、3年和5年累积总生存率分别为88.8%、68.1%和68.1%。单因素分析显示输血（P=0.000）、肝包膜受累（P=0.000）及术后经动脉化疗（P=0.049）与生存显著相关。多因素分析表明输血（P=0.001）和肝包膜受累（P=0.000）是生存的独立预后因素。
对于符合米兰标准、肝功能代偿的早期肝细胞癌患者，肝切除术是首选的治疗策略。
