Zhong Jian-Hong, Pan Ling-Hui, Wang Yan-Yan, Cucchetti Alessandro, Yang Tian, You Xue-Mei, Ma Liang, Gong Wen-Feng, Xiang Bang-De, Peng Ning-Fu, Wu Fei-Xiang, Li Le-Qun
Department of Hepatobiliary Surgery Anesthesia Department, Affiliated Tumor Hospital of Guangxi Medical University, Nanning, Guangxi, China Department of Medical and Surgical Sciences, S.Orsola-Malpighi Hospital, Alma Mater Studiorum, University of Bologna, Bologna, Italy Department of Hepatobiliary Surgery, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai 201800, China.
Medicine (Baltimore). 2017 Apr;96(15):e6608. doi: 10.1097/MD.0000000000006608.
This study aims to refine the designation for single hepatocellular carcinoma (HCC) >5 cm by comparing the postresection prognosis of these patients with those who have a single-tumor ≤5 cm and those with stage B.Patients with a single-tumor were classified into subgroups based on diameter. Of the 1132 patients analyzed, 426 had a single-tumor >2 and ≤5 cm; 229, a single-tumor >5 and ≤8 cm; 52, a single-tumor >8 and < 10 cm; 150, a single-tumor ≥10 cm; and 275, stage B.Hospital mortality and complications increased with tumor size among the single-tumor subgroups and median survival decreased with increasing of tumor size. Overall survival (OS) among patients with a single-tumor >5 cm was significantly lower than among patients with a single-tumor >2 and ≤5 cm (P ≤ .001), but significantly higher than among patients with clearly stage B (P ≤ .001). Patients with a single-tumor >5 and ≤8 cm showed lower OS than patients with a single-tumor >2 and ≤5 cm (P < .001). Patients with a single-tumor >8 and <10 cm or a single-tumor ≥10 cm showed lower OS than patients with a single-tumor >5 and ≤8 cm (P = .033 and .006), and similar OS to patients with stage B (P = .323).Patients with a single-tumor >5 and ≤8 cm may be assigned to a new stage between early and intermediate. Patients with a single-tumor >8 cm may be assigned to intermediate stage.
本研究旨在通过比较单个肝细胞癌（HCC）>5 cm患者与单个肿瘤≤5 cm患者以及B期患者的切除术后预后，完善对单个肝细胞癌>5 cm的分类。将单个肿瘤患者按直径分为亚组。在分析的1132例患者中，426例单个肿瘤>2 cm且≤5 cm；229例单个肿瘤>5 cm且≤8 cm；52例单个肿瘤>8 cm且<10 cm；150例单个肿瘤≥10 cm；275例为B期。在单个肿瘤亚组中，医院死亡率和并发症随肿瘤大小增加而增加，中位生存期随肿瘤大小增加而降低。单个肿瘤>5 cm患者的总生存期（OS）显著低于单个肿瘤>2 cm且≤5 cm的患者（P≤0.001），但显著高于明确为B期的患者（P≤0.001）。单个肿瘤>5 cm且≤8 cm的患者的OS低于单个肿瘤>2 cm且≤5 cm的患者（P<0.001）。单个肿瘤>8 cm且<10 cm或单个肿瘤≥10 cm的患者的OS低于单个肿瘤>5 cm且≤8 cm的患者（P = 0.033和0.006），与B期患者的OS相似（P = 0.323）。单个肿瘤>5 cm且≤8 cm的患者可归为早期和中期之间的新阶段。单个肿瘤>8 cm的患者可归为中期。
