Chang-Gung Transplantation Institute, Department of Liver and Transplantation Surgery, Chang-Gung Memorial Hospital, Chang-Gung University Medical School, 5 Fu-Hsing Street, Kwei-Shan, Taoyuan, Taiwan.
Eur J Surg Oncol. 2011 Jul;37(7):618-22. doi: 10.1016/j.ejso.2011.04.004. Epub 2011 Jun 2.
Overweight/obesity is currently a common health issue that may cause many diseases, even malignancies. The influence of steatosis on long-term results of surgical treatment for hepatocellular carcinoma (HCC) is not well known. The aim of this study is to analyze the results of hepatectomy for HCC patients with steatosis.
The study included 1048 patients who underwent hepatectomy for HCC from 1999 to 2005. The patients were divided into two groups; group A patients without steatosis (n = 693) and group B patients with steatosis (n = 355). The clinicopathological data and long-term survival were analyzed.
Mean tumor size in group B patients was smaller than that in group A patients (4.61 ± 3.40 vs. 5.91 ± 4.36 cm, p < 0.01). Group B patients showed lower tumor differentiation grade, lower vascular invasion rate and better 5-year overall survival compared to group A patients (61.2% vs. 50.1%, p = 0.001). By multivariate analysis, steatosis was found to be associated with well-differentiated, small-sized, and less α-fetoprotein productive tumors. When focusing on the tumors >5 cm in diameter, group B patients had better survival rate than group A patients (p = 0.041). Vascular invasion and steatosis were independent prognostic factors for the overall survival.
HCC in steatotic liver was less aggressive than that in non-steatotic liver. HCC patients with steatosis have better surgical outcomes than those without steatosis. Vascular invasion and steatosis were independent prognostic factors for the overall survival if tumors were >5 cm in diameter.
超重/肥胖目前是一个常见的健康问题，可能导致许多疾病，甚至恶性肿瘤。脂肪变性对肝细胞癌（HCC）手术治疗的长期结果的影响尚不清楚。本研究旨在分析脂肪变性对 HCC 患者肝切除术结果的影响。
本研究纳入了 1999 年至 2005 年间接受 HCC 肝切除术的 1048 例患者。患者分为两组；无脂肪变性组（A 组，n=693）和脂肪变性组（B 组，n=355）。分析临床病理数据和长期生存情况。
B 组患者的平均肿瘤大小小于 A 组（4.61±3.40 vs. 5.91±4.36cm，p<0.01）。B 组患者的肿瘤分化程度较低，血管侵犯率较低，5 年总生存率高于 A 组（61.2% vs. 50.1%，p=0.001）。多因素分析显示，脂肪变性与分化良好、体积小、甲胎蛋白产量低的肿瘤有关。当关注直径>5cm 的肿瘤时，B 组患者的生存率高于 A 组（p=0.041）。血管侵犯和脂肪变性是总生存的独立预后因素。
脂肪变性肝中的 HCC 比非脂肪变性肝中的 HCC 侵袭性低。脂肪变性的 HCC 患者的手术结果优于无脂肪变性的 HCC 患者。如果肿瘤直径>5cm，则血管侵犯和脂肪变性是总生存的独立预后因素。
