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术后并发症影响肝细胞癌根治性切除术后的早期复发。

Postoperative complications affect early recurrence of hepatocellular carcinoma after curative resection.

作者信息

Zhou Yan-Ming, Zhang Xiao-Feng, Li Bin, Sui Cheng-Jun, Yang Jia-Mei

机构信息

Department of Hepatobiliary & Pancreatovascular Surgery, First affiliated Hospital of Xiamen University, Xiamen, China.

Department of Special Treatment, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai, China.

出版信息

BMC Cancer. 2015 Oct 14;15:689. doi: 10.1186/s12885-015-1720-0.

Abstract

BACKGROUND

Postoperative recurrence remains the major cause of death after curative resection for hepatocellular carcinoma (HCC). This study was conducted to evaluate the impact of postoperative complications on HCC recurrence after curative resection.

METHODS

The postoperative outcomes of 274 HCC patients who underwent curative resection were analysed retrospectively.

RESULTS

Of the 247 HCC patients, 103 (37.6 %) patients developed postoperative complications. The occurrence of postoperative complications was found to be associated with a significantly higher tumor recurrence (76.2 % vs. 56.6 %, P = 0.002) and a lower 5-year overall survival rate (27.7 % vs. 42.1 %; P = 0.037) as compared with those without complications. Regarding the recurrence pattern, early recurrence (≤2 years) was more frequently seen in patients with complications than that in patients without complications (54.5 % vs.38.6 %; P = 0.011). Multivariate analysis indicated that postoperative complications occurrence was an independent risk factor for early recurrence (odds ratio [OR] 2.223; 95 % confidence intervals [95 % CI] 1.161-4.258, P = 0.016) and poor overall survival (OR 1.413; 95 % CI, 1.012-1.971, P = 0.042).

CONCLUSIONS

The results of the present study indicate that the occurrence of postoperative complications is a predictive factor for HCC recurrence after curative hepatectomy, especially for early recurrence.

摘要

背景

术后复发仍然是肝细胞癌(HCC)根治性切除术后死亡的主要原因。本研究旨在评估术后并发症对HCC根治性切除术后复发的影响。

方法

回顾性分析274例行根治性切除的HCC患者的术后结局。

结果

247例HCC患者中,103例(37.6%)发生术后并发症。与无并发症患者相比,术后并发症的发生与肿瘤复发率显著升高(76.2%对56.6%,P = 0.002)及5年总生存率降低(27.7%对42.1%;P = 0.037)相关。就复发模式而言,有并发症患者的早期复发(≤2年)比无并发症患者更常见(54.5%对38.6%;P = 0.011)。多因素分析表明,术后并发症的发生是早期复发(比值比[OR] 2.223;95%置信区间[95%CI] 1.161 - 4.258,P = 0.016)和总体生存不良(OR 1.413;95%CI,1.012 - 1.971,P = 0.042)的独立危险因素。

结论

本研究结果表明,术后并发症的发生是HCC根治性肝切除术后复发的预测因素,尤其是早期复发。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f738/4604633/ce0fb79acd97/12885_2015_1720_Fig1_HTML.jpg

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