Kondo Kazuhiro, Chijiiwa Yoshiro, Otani Kazuhiro, Kai Masahiro, Ohuchida Jiro, Chijiiwa Kazuo
Department of Surgical Oncology and Regulation of Organ Function, Miyazaki University School of Medicine, Miyazaki, Japan.
Hepatogastroenterology. 2012 Oct;59(119):2269-72. doi: 10.5754/hge10649.
BACKGROUND/AIMS: Hepatocellular carcinoma (HCC) patients often have low platelet count (LPC). The aim of this study was to determine unique features of HCC patients with LPC.
HCC patients who underwent surgery were divided into two groups: LPC group (platelet count ≤100,000/mm³, n=84) and control group (platelet count >100,000/mm³, n=240). Surgical outcomes, risk factors for postoperative complications and prognostic factors were retrospectively compared.
HCC patients with LPC had poorer liver function, smaller tumors, less anatomical resection and more frequent postoperative liver failure than control group patients. Postoperative survival was not different between the two groups. Tumor invasion to the main branch or trunk of portal vein (Vp3, 4) was the only risk factor for postoperative substantial complications in the LPC group. Postoperative survival was worse in patients with tumor diameter ≥4 cm or multiple tumors and in those who underwent preoperative transcatheter arterial chemoembolization (TACE) in the LPC group by multivariate analysis. Among them, preoperative TACE were not prognostic factors in the control group.
In HCC patients with LPC, Vp3, 4 patients should be carefully monitored after surgery and preoperative TACE is not recommended for long-term postoperative survival.
背景/目的：肝细胞癌（HCC）患者常伴有血小板计数偏低（LPC）。本研究旨在确定伴有LPC的HCC患者的独特特征。
将接受手术的HCC患者分为两组：LPC组（血小板计数≤100,000/mm³，n = 84）和对照组（血小板计数>100,000/mm³，n = 240）。回顾性比较手术结果、术后并发症的危险因素和预后因素。
与对照组患者相比，伴有LPC的HCC患者肝功能较差、肿瘤较小、解剖性切除较少且术后肝衰竭更频繁。两组患者术后生存率无差异。肿瘤侵犯门静脉主支或主干（Vp3、4）是LPC组术后严重并发症的唯一危险因素。多因素分析显示，LPC组中肿瘤直径≥4 cm或多发肿瘤的患者以及接受术前经动脉化疗栓塞术（TACE）的患者术后生存率较差。其中，术前TACE在对照组中不是预后因素。
在伴有LPC的HCC患者中，Vp3、4患者术后应密切监测，不建议进行术前TACE以实现长期术后生存。
