Toshikuni Nobuyuki, Takuma Yoshitaka, Goto Tomoyuki, Yamamoto Hiroshi
Department of Gastroenterology and Hepatology, Kurashiki Central Hospital, Kurashiki, Japan.
Hepatogastroenterology. 2012 Nov-Dec;59(120):2361-6. doi: 10.5754/hge12934.
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.
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.
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.
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.
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。
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。
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。
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。