Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong Special Administrative Region.
Surgeon. 2012 Oct;10(5):260-6. doi: 10.1016/j.surge.2011.07.004. Epub 2011 Sep 9.
To determine the predictors for recurrence in patients receiving curative hepatectomy for hepatocellular carcinoma (HCC).
From January 2001 to July 2007, all patients having hepatectomy for first occurrence HCC with curative intent were identified from a prospectively collected database. Prognostic factors for recurrence and survival after resection were analyzed.
A total of 235 patients were included. With a median follow-up of 50.2 (0.07-125.1) months, the recurrence rate was 57.0%. The 1-, 3-, and 5-year overall survival rates were 83.9%, 66.0%, and 58.1% respectively. Multivariate analysis demonstrated that multi-focal lesions (HR: 2.93, P < 0.001), alpha-fetoprotein (AFP) level greater than 100 ng/ml (HR: 1.74, P = 0.002) and history of tumor rupture (HR: 2.84, P = 0.003) were independent risk factors for recurrence of HCC after hepatectomy.
Predictors for HCC recurrence can be identified before operation. These important parameters should be considered before and after contemplating curative resection for HCC patients and for risk stratification in future clinical trials for neoadjuvant or post-resection adjuvant therapy. The possible use of neoadjuvant or adjuvant treatment to improve survival should be addressed by further trials.
确定接受根治性肝切除术治疗肝细胞癌（HCC）患者复发的预测因素。
从 2001 年 1 月至 2007 年 7 月，从一个前瞻性收集的数据库中确定了所有接受根治性肝切除术治疗初发 HCC 的患者。分析了术后复发和生存的预后因素。
共纳入 235 例患者。中位随访时间为 50.2（0.07-125.1）个月，复发率为 57.0%。1、3、5 年总生存率分别为 83.9%、66.0%和 58.1%。多因素分析表明，多发病灶（HR：2.93，P<0.001）、甲胎蛋白（AFP）水平>100ng/ml（HR：1.74，P=0.002）和肿瘤破裂史（HR：2.84，P=0.003）是肝癌切除术后 HCC 复发的独立危险因素。
可以在手术前确定 HCC 复发的预测因素。在考虑对 HCC 患者进行根治性切除术前和术后，这些重要参数应加以考虑，并在未来新辅助或术后辅助治疗的临床试验中进行风险分层。进一步的试验可能需要探讨新辅助或辅助治疗以提高生存率的可能性。
