Zhang Y, Wang L M, Wu F, Rong W Q, Lin S T, Liu Y H, Zheng Y L, Wu J X
Department of Hepatobiliary Surgery, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021.
Zhonghua Zhong Liu Za Zhi. 2017 May 23;39(5):389-394. doi: 10.3760/cma.j.issn.0253-3766.2017.05.014.
To analyze the clinicopathological features and prognosis of patients with small hepatocellular carcinoma. The clinicopathological and follow-up data of 98 patients with small hepatocellular carcinoma who underwent R0 resection from January 2009 to December 2013 were analyzed retrospectively. All of the patients were followed up. Their postoperative 1-year, 3-year and 5-year overall survival rates were 99.0%, 91.7%, and 76.3%, respectively. Their postoperative median overall survival (OS) period was 52 months. The postoperative progression-free survival rates were 86.7%, 66.2% and 55.0%, respectively, and the median progression-free survival (PFS) period was 43.5 months. The univariate analysis showed that satellite nodules, liver capsule invasion and postoperative recurrence time were associated with OS (<0.05), and long-term heavy drinking, satellite nodules and liver capsule invasion with PFS (<0.05). The multivariate analysis indicated that long-term heavy drinking was an independent factor influencing the progression-free survival period of patients with small hepatocellular carcinoma (=0.003) and postoperative recurrence time and liver capsule invasion were independent factors affecting their overall survival period (<0.05). The treatment of small hepatocellular carcinoma still concentrates on the active treatment of surgery. It is beneficial to patients to minimize the resection scope of normal liver under the premise of R0 removal of tumor. Postoperative recurrence time of ≤2 years suggests poor prognosis of small hepatocellular carcinoma. Long-term heavy drinking can accelerate the recurrence of small hepatocellular carcinoma.
分析小肝细胞癌患者的临床病理特征及预后。回顾性分析2009年1月至2013年12月期间接受R0切除的98例小肝细胞癌患者的临床病理及随访资料。所有患者均进行了随访。其术后1年、3年和5年总生存率分别为99.0%、91.7%和76.3%。术后中位总生存(OS)期为52个月。术后无进展生存率分别为86.7%、66.2%和55.0%,中位无进展生存(PFS)期为43.5个月。单因素分析显示,卫星结节、肝包膜侵犯及术后复发时间与总生存相关(<0.05),长期大量饮酒、卫星结节及肝包膜侵犯与无进展生存相关(<0.05)。多因素分析表明,长期大量饮酒是影响小肝细胞癌患者无进展生存期的独立因素(=0.003),术后复发时间及肝包膜侵犯是影响其总生存期的独立因素(<0.05)。小肝细胞癌的治疗仍集中在积极的手术治疗上。在R0切除肿瘤的前提下,尽量缩小正常肝脏的切除范围对患者有益。术后复发时间≤2年提示小肝细胞癌预后不良。长期大量饮酒可加速小肝细胞癌的复发。