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[预测符合米兰标准的肝细胞癌肝移植和肝切除术后结局的因素]

[Factors for predicting outcomes of liver transplantation and liver resection for hepatocellular carcinoma meeting Milan criteria].

作者信息

Huang Junhai, Zhou Jie

机构信息

Department of Hepatobiliary Surgery, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China. E-mail:

出版信息

Nan Fang Yi Ke Da Xue Xue Bao. 2014 Mar;34(3):406-9.

Abstract

OBJECTIVE

To investigate the risk factors affecting neoplasm recurrence and metastasis following liver transplantation (LT) and liver resection (LR) in patients with hepatocellular carcinoma (HCC) meeting Milan criteria.

METHODS

We retrospectively analyzed the clinical data of 88 patients with HCC meeting Milan criteria undergoing LT or LR in Nanfang Hospital between January, 2006 and December, 2011 and compared the survival rate and recurrence-free survival rate between the two groups. Univariate analysis of 12 variables during peri-operative period was carried out to screen the risk factors affecting neoplasm recurrence and metastasis.

RESULTS

The LT group and HR group had similar 1-, 3-, and 5-year-survival rates (P>0.05), but the LT group showed significantly higher 1-, 3-, and 5-year recurrence-free survival rates (P<0.05). The recurrence rate was much lower in LT group than in LR group (P<0.05). Multivariate analysis identified gender, tumor size, degree of pathological differentiation, and microvascular tumor embolism as independent risk factors affecting the recurrence-free survival rate.

CONCLUSION

Patients with HCC meeting Milan criteria undergoing LT have longer long-term recurrence-free survival. A male patient with a greater tumor size, microvascular tumor embolism, and poorly differentiated carcinoma is more likely to develop neoplasm recurrence and metastasis following the surgery.

摘要

目的

探讨符合米兰标准的肝细胞癌(HCC)患者肝移植(LT)和肝切除(LR)后影响肿瘤复发和转移的危险因素。

方法

回顾性分析2006年1月至2011年12月在南方医院接受LT或LR的88例符合米兰标准的HCC患者的临床资料,比较两组的生存率和无复发生存率。对围手术期12个变量进行单因素分析,以筛选影响肿瘤复发和转移的危险因素。

结果

LT组和HR组的1年、3年和5年生存率相似(P>0.05),但LT组的1年、3年和5年无复发生存率显著更高(P<0.05)。LT组的复发率远低于LR组(P<0.05)。多因素分析确定性别、肿瘤大小、病理分化程度和微血管肿瘤栓塞是影响无复发生存率的独立危险因素。

结论

符合米兰标准的HCC患者接受LT后长期无复发生存期更长。男性、肿瘤较大、有微血管肿瘤栓塞且癌组织分化差的患者术后更易发生肿瘤复发和转移。

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