Alvite Canosa Marlén, Pita Fernández Salvador, Quintela Fandiño Julia, Aguirrezabalaga Javier, Otero Alejandra, Suárez Francisco, Corbal Gerardo, Fernández Carlos, Gutiérrez Manuel Gómez
Unidad de Cirugía Hepatobiliopancreática y Trasplante Hepático, Complejo Hospitalario Universitario de A Coruña, A Coruña, España.
Cir Esp. 2011 Apr;89(4):223-9. doi: 10.1016/j.ciresp.2010.12.002. Epub 2011 Feb 26.
Liver cancer (LC) is one of the most frequent tumours, in which the potentially curative treatment is surgery: partial surgical resection or liver transplant.
To determine the morbidity and mortality, survival, and their associated factors in patients with LC, according to the type of surgical treatment: partial surgical resection or liver transplant.
A retrospective, observational follow-up study of LC patients diagnosed and treated from June 1994 to December 2007. A descriptive analysis of the variables was performed, as well as a Kaplan- Meier survival analysis and Cox regression.
The incidence of tumour recurrence in the 150 transplant patients was 13.3%, with a survival at 1, 3, and 5 years of 89.3%, 73.1% and 61.4%, respectively. The multivariate analysis showed that only the histological grade/differentiation was an independent risk factor. In the 33 patients with partial surgical resection, the incidence of tumour was 51.5%, with a survival at 1, 3, and 5 years of 90.9%, 60.2%, and 38.6%, respectively. A significantly higher mortality was observed in patients with higher tumour and TNM staging.
The survival throughout follow-up was higher in liver transplant, and tumour recurrence was more frequent in patients with partial surgical resection. The survival results in transplanted patients are consistent with the Spanish and European Liver Transplant Register and with the United Network for Organ Sharing register.
肝癌是最常见的肿瘤之一，其潜在的根治性治疗方法是手术：部分手术切除或肝移植。
根据手术治疗类型（部分手术切除或肝移植），确定肝癌患者的发病率、死亡率、生存率及其相关因素。
对1994年6月至2007年12月诊断和治疗的肝癌患者进行回顾性观察随访研究。对变量进行描述性分析，以及Kaplan-Meier生存分析和Cox回归分析。
150例移植患者的肿瘤复发率为13.3%，1年、3年和5年生存率分别为89.3%、73.1%和61.4%。多因素分析显示，只有组织学分级/分化是独立危险因素。在33例接受部分手术切除的患者中，肿瘤发生率为51.5%，1年、3年和5年生存率分别为90.9%、60.2%和38.6%。肿瘤和TNM分期较高的患者死亡率显著更高。
肝移植患者的随访期生存率更高，部分手术切除患者的肿瘤复发更频繁。移植患者的生存结果与西班牙和欧洲肝移植登记处以及器官共享联合网络登记处的数据一致。
