Lewis Richard H, Glazer Evan S, Bittenbinder David M, O'Brien Thomas, Deneve Jeremiah L, Shibata David, Behrman Stephen W, Vanatta Jason M, Satapathy Sanjaya K, Dickson Paxton V
Department of Surgery, Division of Surgical Oncology, University of Tennessee Health Science Center, 910 Madison Avenue, 3rd Floor, Memphis, TN, 38163, USA.
West Cancer Center, Memphis, TN, USA.
J Gastrointest Cancer. 2019 Dec;50(4):808-815. doi: 10.1007/s12029-018-0152-x.
Hepatocellular carcinoma (HCC) occasionally occurs in non-cirrhotic patients; however, outcomes for these patients are not extensively documented.
We performed an institutional review of patients without cirrhosis who underwent resection for HCC. Clinical data were evaluated to identify factors impacting recurrence-free survival (RFS) and overall survival (OS).
Forty-two patients underwent hepatectomy for HCC in the absence of cirrhosis over a 10-year period. Median follow-up was 22 months. For the entire cohort, 1-, 3-, and 5-year RFS was 62%, 42%, and 38% and 1-, 3-, and 5-year OS was 78%, 60%, and 49%, respectively. On univariate analysis, RFS was significantly worse for patients with a disrupted/absent tumor capsule (p = 0.027), vascular invasion (p = 0.030), elevated alkaline phosphatase (p = 0.004), and tumor size > 10 cm (p = 0.016). OS was significantly worse for patients with a disrupted/absent tumor capsule (p = 0.044), obesity (p = 0.036), and elevated alkaline phosphatase (p = 0.007) with a trend towards decreased OS for tumor size > 10 cm (p = 0.07).
Patients undergoing resection for HCC in the absence of cirrhosis have fairly high recurrence and modest survival rates. Pre-operative alkaline phosphatase, tumor size, tumor encapsulation, and vascular invasion are important prognostic factors.
肝细胞癌（HCC）偶尔会在非肝硬化患者中发生；然而，这些患者的预后情况尚无详尽记录。
我们对未患肝硬化且接受了HCC切除术的患者进行了一项机构性回顾研究。评估临床数据以确定影响无复发生存期（RFS）和总生存期（OS）的因素。
在10年期间，42例无肝硬化的患者接受了HCC肝切除术。中位随访时间为22个月。对于整个队列，1年、3年和5年的RFS分别为62%、42%和38%，1年、3年和5年的OS分别为78%、60%和49%。单因素分析显示，肿瘤包膜破裂/缺失（p = 0.027）、血管侵犯（p = 0.030）、碱性磷酸酶升高（p = 0.004）以及肿瘤大小>10 cm（p = 0.016）的患者RFS明显更差。肿瘤包膜破裂/缺失（p = 0.044）、肥胖（p = 0.036）以及碱性磷酸酶升高（p = 0.007）的患者OS明显更差，肿瘤大小>10 cm的患者OS有下降趋势（p = 0.07）。
未患肝硬化而接受HCC切除术的患者复发率相当高，生存率一般。术前碱性磷酸酶、肿瘤大小、肿瘤包膜及血管侵犯是重要的预后因素。
