体重指数对非 B 非 C 型肝细胞癌治愈性治疗后生存的影响。

Effect of body mass index on survival after curative therapy for non-B non-C hepatocellular carcinoma.

机构信息

Department of Gastroenterology and Hepatology, Osaka Red Cross Hospital, Japan.

出版信息

J Gastrointestin Liver Dis. 2013 Jun;22(2):173-81.

Abstract

BACKGROUND & AIMS: The impact of obesity on survival after curative treatment for non-B non-C hepatocellular carcinoma (NBNC-HCC) remains unclear. This study examined the prognostic impact of obesity in patients who received curative therapy for NBNC-HCC.

METHODS

A total of 260 patients with NBNC-HCC who underwent curative therapy were analyzed. They included 116 obese patients (44.6%) with a body mass index (BMI) >25 kg/m² (obesity group) and 144 control patients (55.4%) with a BMI <25 kg/m² (control group). Overall survival (OS) and recurrence-free survival (RFS) rates were compared.

RESULTS

The median observation periods in the obesity and control groups were 3.1 and 3.0 years, respectively. The 1-, 3- and 5-year cumulative OS rates were 93.9%, 77.3% and 56.0% in the obesity group, and 98.8%, 77.3% and 62.1% in the control group, respectively (p = 0.955). The corresponding RFS rates were 74.6%, 28.0% and 19.0% in the obesity group, and 70.0%, 44.3% and 28.9%, in the control group, respectively (p = 0.128). Multivariate analyses identified a serum albumin >4.0 g/dL (hazard ratio [HR], 1.759; 95% confidence interval [CI], 1.007-3.074; p = 0.047) and des-γ-carboxy prothrombin >100 mAU/mL (HR, 0.396; 95% CI, 0.243-0.646; p < 0.001) as independent factors linked to OS. Alkaline phosphatase>300 IU/L (HR, 0.549; 95% CI, 0.367-0.823; p = 0.004) and gamma-glutamyl transferase >100 IU/L (HR, 0.679; 95% CI, 0.471-0.978; p = 0.038) were significant adverse predictors linked to RFS.

CONCLUSIONS

Obesity does not affect survival in patients with NBNC-HCC after curative therapy.

摘要

背景与目的

肥胖对非乙型肝炎非丙型肝炎肝细胞癌（NBNC-HCC）患者根治性治疗后生存的影响尚不清楚。本研究旨在探讨肥胖对接受 NBNC-HCC 根治性治疗患者预后的影响。

方法

共分析了 260 例接受根治性治疗的 NBNC-HCC 患者，其中 116 例肥胖患者（44.6%）BMI＞25kg/m²（肥胖组），144 例对照患者（55.4%）BMI＜25kg/m²（对照组）。比较两组患者的总生存（OS）率和无复发生存（RFS）率。

结果

肥胖组和对照组的中位观察期分别为 3.1 年和 3.0 年。肥胖组 1、3 和 5 年累积 OS 率分别为 93.9%、77.3%和 56.0%，对照组分别为 98.8%、77.3%和 62.1%（p=0.955）。肥胖组和对照组的相应 RFS 率分别为 74.6%、28.0%和 19.0%，44.3%、28.9%和 14.3%（p=0.128）。多因素分析显示，血清白蛋白＞4.0g/dL（HR，1.759；95%CI，1.007-3.074；p=0.047）和去γ-羧基凝血酶原＞100mAU/mL（HR，0.396；95%CI，0.243-0.646；p＜0.001）为 OS 的独立预后因素。碱性磷酸酶＞300IU/L（HR，0.549；95%CI，0.367-0.823；p=0.004）和γ-谷氨酰转移酶＞100IU/L（HR，0.679；95%CI，0.471-0.978；p=0.038）是 RFS 的显著不良预测因素。