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肝肉瘤样癌患者后续手术治疗的预后:一项回顾性研究。

The prognosis of subsequent surgical treatment in patients with sarcomatoid carcinoma in the liver: A retrospective study.

机构信息

Department of Hepatobiliary Oncology, Sun Yat-sen University Cancer Center, Guangzhou, 510060, China.

Department of Hepatobiliary Oncology, Sun Yat-sen University Cancer Center, Guangzhou, 510060, China.

出版信息

Int J Surg. 2018 Jul;55:145-151. doi: 10.1016/j.ijsu.2018.05.736. Epub 2018 May 31.

Abstract

BACKGROUND

Sarcomatoid hepatocellular carcinoma (SHC) is a rare disease with a poor prognosis. Due to the scarcity of patients with this condition, the optimal treatment for SHC has not been established. In this study, we compared the benefits of subsequent treatments for surgical SHC patients.

MATERIALS AND METHODS

Clinical records were retrospectively studied. The SHC patients were divided into two groups according to whether subsequent treatment was performed. The overall survival (OS) rates and disease-free survival (DFS) rates were estimated by the Kaplan-Meier method, and comparisons were made using the log-rank test. Univariate and multivariate analyses were evaluated using the Cox proportional hazards regression model.

RESULTS

The study included 25 patients; 9 (36%) had subsequent treatments following surgery. The median OS of the treatment group and non-treatment group were 8.8 months [95% confidence interval (CI) 8.4-9.1] and 5.4 months [95% CI 4.3-6.5], respectively. OS showed statistical significance between the two groups (log-rank, P = 0.025). Univariate analysis suggested that two factors were poor predictors of OS: without subsequent treatment and with capsule formation. Multivariate analysis demonstrated that only subsequent treatment significantly influenced OS.

CONCLUSION

After surgery, SHC patients with subsequent treatment showed better outcomes. However, a more effective treatment is yet to be found. Further studies with a larger patient population are needed.

摘要

背景

肉瘤样肝细胞癌 (SHC) 是一种罕见的疾病,预后较差。由于此类患者数量稀少,尚未确定 SHC 的最佳治疗方法。在本研究中,我们比较了手术治疗 SHC 患者的后续治疗效果。

材料与方法

回顾性研究临床记录。根据是否进行后续治疗,将 SHC 患者分为两组。采用 Kaplan-Meier 法估计总生存期 (OS) 和无病生存期 (DFS),采用对数秩检验进行比较。采用 Cox 比例风险回归模型进行单因素和多因素分析。

结果

本研究共纳入 25 例患者;9 例(36%)手术后进行了后续治疗。治疗组和非治疗组的中位 OS 分别为 8.8 个月(95%CI 8.4-9.1)和 5.4 个月(95%CI 4.3-6.5)。两组 OS 差异有统计学意义(log-rank,P=0.025)。单因素分析表明,无后续治疗和包膜形成是 OS 的两个不良预测因素。多因素分析表明,只有后续治疗对 OS 有显著影响。

结论

手术后,接受后续治疗的 SHC 患者的预后更好。然而,仍需寻找更有效的治疗方法。需要进行更大规模患者人群的进一步研究。

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