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原发性肝细胞癌继发转移性脊髓压迫症的多学科治疗结果

Outcomes of metastatic spinal cord compression secondary to primary hepatocellular carcinoma with multidisciplinary treatments.

作者信息

He Shaohui, Wei Haifeng, Ma Yifei, Zhao Jian, Xu Wei, Xiao Jianru

机构信息

Department of Orthopedic Oncology, Spinal Tumor Center, Changzheng Hospital, Second Military Medical University, Shanghai, China.

出版信息

Oncotarget. 2017 Jun 27;8(26):43439-43449. doi: 10.18632/oncotarget.15708.

Abstract

Few studies have reported progression-free survival (PFS) and overall survival (OS) of Metastatic spinal cord compression (MSCC) patients with primary hepatocellular carcinoma (HCC) following surgery and adjuvant therapies. Enrolled in this study were 155 MSCC patients with primary HCC who received surgery and adjuvant therapies between 2000 and 2015. Kaplan-Meier methods and Cox's proportional hazards regression mode were performed to investigate the clinical features and prognostic factors affecting PFS and OS. The median PFS and OS was 7.0 months and 9.7 months, respectively. 92.9% patients responded well to surgery according to the Visual Analogue Scale, Frankel Score and postoperative complication occurrences. 68 (43.9%) patients who received circumferential decompression achieved better PFS than the remaining 87 (56.1%) patients who received laminectomy. Favorable outcomes were achieved after surgery during the perioperative period. Circumferential decompression was associated with better PFS than laminectomy. The postoperative Frankel Score E, Eastern Cooperative Oncology Group performance score of 1 or 2, no visceral metastasis, administration of postoperative radiation and the use of Sorafenib were found to be significant predictors of better PFS and OS. Patients who previously underwent resection of primary HCC with/without liver transplantation tended to have a better OS.

摘要

很少有研究报告过接受手术及辅助治疗的原发性肝细胞癌(HCC)伴发转移性脊髓压迫(MSCC)患者的无进展生存期(PFS)和总生存期(OS)。本研究纳入了2000年至2015年间接受手术及辅助治疗的155例原发性HCC伴发MSCC患者。采用Kaplan-Meier法和Cox比例风险回归模型来研究影响PFS和OS的临床特征及预后因素。PFS和OS的中位数分别为7.0个月和9.7个月。根据视觉模拟评分、Frankel评分及术后并发症发生率,92.9%的患者对手术反应良好。68例(43.9%)接受环形减压的患者比其余87例(56.1%)接受椎板切除术的患者获得了更好的PFS。围手术期手术取得了良好的效果。与椎板切除术相比,环形减压与更好的PFS相关。术后Frankel评分E、东部肿瘤协作组体能状态评分为1或2、无内脏转移、术后放疗及使用索拉非尼被发现是PFS和OS更佳的显著预测因素。既往接受过原发性HCC切除(伴或不伴肝移植)的患者往往有更好的OS。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/125f/5522159/ad88f5a74f4f/oncotarget-08-43439-g001.jpg

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