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索拉非尼治疗肝细胞癌患者总生存的影响因素。

Factors contributing to the overall survival in patients with hepatocellular carcinoma treated by sorafenib.

作者信息

Tsukui Yuya, Mochizuki Hitoshi, Hoshino Yuji, Kawakami Satoshi, Kuno Toru, Fukasawa Yoshimitsu, Iwamoto Fumihiko, Hirose Sumio, Yoshida Takashi, Hosoda Kenji, Suzuki Youji, Hosoda Kazuhiko, Kojima Yuichiro, Hirose Yuichi, Shindou Kuniaki, Matsuda Masanori, Yagawa Syoji, Tawara Akio, Kobayashi Masashi, Konishi Toshiyuki, Yamazaki Takahisa, Takahashi Seiichiro, Fuji Hideki, Enomoto Nobuyuki, Omata Masao

机构信息

Department of Gastroenterology, Yamanashi Central Hospital, Yamanashi, Japan.

出版信息

Hepatogastroenterology. 2012 Nov-Dec;59(120):2536-9. doi: 10.5754/hge12059.

Abstract

BACKGROUND/AIMS: In both SHARP and Asia-Pacific Study, sorafenib was proved to improve the overall survival of the patients with hepatocellular carcinoma. However, factors contributing to the improvement of overall survival of the patients treated by sorafenib have not been fully evaluated. In this study, patient-derived, background liver disease-derived and tumor-derived factors before treatment were evaluated whether they have contributed to the improvement of the overall survival.

METHODOLOGY

Forty-seven cases with HCC treated by sorafenib between Sept 2009 and Feb 2011 were included in this analysis. The survival of these cases was analyzed by Kaplan-Meier Method. Factors used for univariate analysis were two patient-derived parameters, two background liver disease-derived, five tumor-derived. Factors related to the over-all survival were analyzed by multivariate analysis using Cox regression model.

RESULTS

In the multivariate analysis, only background liver disease-derived parameter Child-Pugh class A vs. B, (p=0.007, HR=0.21 (0.07-0.65)) was significant. No other parameters including tumor-derived factors were statistically significant by multivariate analysis.

CONCLUSIONS

We undertook the statistical analysis on the three categories. Surprisingly, no tumor derived parameter contributed to the overall survival. Background liver disease-derived parameter rather than tumor-derived parameter was found to define the prognosis of patients with advanced HCC treated by sorafenib.

摘要

背景/目的:在索拉非尼治疗晚期肝细胞癌的SHARP研究和亚太地区研究中,索拉非尼均被证实可提高患者的总生存率。然而,索拉非尼治疗患者总生存率提高的相关因素尚未得到充分评估。本研究评估了治疗前患者来源、背景肝病来源和肿瘤来源的因素是否有助于提高总生存率。

方法

本分析纳入了2009年9月至2011年2月间接受索拉非尼治疗的47例肝癌患者。采用Kaplan-Meier法分析这些患者的生存率。单因素分析使用的因素包括两个患者来源参数、两个背景肝病来源参数和五个肿瘤来源参数。采用Cox回归模型进行多因素分析,以分析与总生存率相关的因素。

结果

多因素分析中,仅背景肝病来源参数Child-Pugh A级与B级有显著差异(p = 0.007,HR = 0.21(0.07 - 0.65))。多因素分析中,包括肿瘤来源因素在内的其他参数均无统计学意义。

结论

我们对这三类因素进行了统计分析。令人惊讶的是,没有肿瘤来源参数对总生存率有影响。发现背景肝病来源参数而非肿瘤来源参数决定了索拉非尼治疗的晚期肝癌患者的预后。

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