Division of Surgical Oncology, Department of Translational Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki 8528501, Japan.
Anticancer Res. 2011 Dec;31(12):4545-51.
To clarify perioperative factors associated with poor survival following hepatectomy.
Clinical parameters and stress score, including surgical stress score (SSS) and comprehensive risk score (CRS) were examined from 183 hepatocellular carcinoma patients who underwent hepatectomy.
Factors associated with tumor relapse were increased blood loss/weight, uncontrolled ascites and grade B liver damage (p<0.05). Ascites was identified as an independent risk factor by multivariate logistic regression analysis. Increased blood loss/weight, transfusion, high SSS, high CRS, ascites, and grade B liver damage were associated with poor disease-free survival (p<0.05). Increased blood loss/weight, transfusion, ascites, and grade B liver damage were associated with poor overall survival (p<0.05), and ascites, transfusion, male sex and grade B liver damage were identified as independent risk factors.
Reducing blood loss and avoiding transfusion appear important for improving prognosis. Maintenance of liver function is necessary in cases showing poor liver function and uncontrolled ascites.
阐明肝切除术后生存不良的围手术期相关因素。
对 183 例接受肝切除术的肝细胞癌患者的临床参数和应激评分（包括手术应激评分（SSS）和综合风险评分（CRS））进行了检查。
与肿瘤复发相关的因素包括出血量/体重增加、腹水未得到控制和肝功能 B 级损害（p<0.05）。腹水通过多变量逻辑回归分析被确定为独立危险因素。出血量/体重增加、输血、SSS 高、CRS 高、腹水和肝功能 B 级损害与无疾病生存不良相关（p<0.05）。出血量/体重增加、输血、腹水和肝功能 B 级损害与总体生存不良相关（p<0.05），腹水、输血、男性和肝功能 B 级损害被确定为独立危险因素。
减少出血量和避免输血对于改善预后很重要。对于肝功能不良和腹水未得到控制的病例，维持肝功能是必要的。
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