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射频消融术后单发小肝细胞癌丙型肝炎患者的预后因素

Prognostic factors in hepatitis C patients with a single small hepatocellular carcinoma after radiofrequency ablation.

作者信息

Toshikuni Nobuyuki, Takuma Yoshitaka, Goto Tomoyuki, Yamamoto Hiroshi

机构信息

Department of Gastroenterology and Hepatology, Kurashiki Central Hospital, Kurashiki, Japan.

出版信息

Hepatogastroenterology. 2012 Nov-Dec;59(120):2361-6. doi: 10.5754/hge12934.

Abstract

BACKGROUND/AIMS: Hepatitis C is a major cause of hepatocellular carcinoma (HCC). Radiofrequency ablation (RFA) has been widely performed as a curative treatment for small HCC. The knowledge of prognostic factors in hepatitis C patients with small HCC after RFA is therefore important.

METHODOLOGY

One hundred consecutive hepatitis C patients with a single HCC3cm or less treated with RFA were enrolled. The cumulative recurrence and survival rates were calculated using Kaplan-Meier analysis. Prognostic factors were investigated using the Cox proportional hazard mod-el.

RESULTS

Five-year local and distant intra hepatic recurrence rates were 10.4% and 70.9%, respectively. Five-year overall survival and recurrence-free survival rates were 60.3% and 15.9%, respectively. Multivarlate analysis revealed that an age of 75 years or more[relative hazard (RH) 1.61, p=0.019] and a serum al-bumin level less than 3.5g/dL (RH 1.61, p=0.016)were significant factors for decreased overall survival. Furthermore, a serum albumin level less than 3.5g/dL (RH 1.50, p=0.003) was the only significant factor for decreased recurrence-free survival.

CONCLUSIONS

This study suggests that host-related factors (age and serum albumin level) are important in predicting survival in hepatitis C patients with a single small HCC af-ter RFA.

摘要

背景/目的:丙型肝炎是肝细胞癌(HCC)的主要病因。射频消融(RFA)已被广泛应用于小肝癌的根治性治疗。因此,了解RFA术后丙型肝炎小肝癌患者的预后因素非常重要。

方法

连续纳入100例接受RFA治疗的单个HCC直径3cm及以下的丙型肝炎患者。采用Kaplan-Meier分析计算累积复发率和生存率。使用Cox比例风险模型研究预后因素。

结果

5年局部和肝内远处复发率分别为10.4%和70.9%。5年总生存率和无复发生存率分别为60.3%和15.9%。多因素分析显示,年龄75岁及以上(相对风险[RH]1.61,p=0.019)和血清白蛋白水平低于3.5g/dL(RH 1.61,p=0.016)是总生存降低的显著因素。此外,血清白蛋白水平低于3.5g/dL(RH 1.50,p=0.003)是无复发生存降低的唯一显著因素。

结论

本研究表明,宿主相关因素(年龄和血清白蛋白水平)对预测RFA术后单个小肝癌丙型肝炎患者的生存很重要。

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