Department of Medical Statistics & Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, PR China.
Department of Hepatobiliary & Pancreatic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Shenzhen, PR China.
Future Oncol. 2019 Jun;15(17):2041-2051. doi: 10.2217/fon-2019-0117. Epub 2019 Apr 10.
The present study aimed to determine whether anatomical resection was necessary for early hepatocellular carcinoma. A log-rank test or two-stage test was used for univariate analysis. A Cox proportional hazards model was used for multivariable analysis. For patients without microvascular invasion, a resection margin ≥1 cm provided the longest recurrence-free survival time regardless of whether they underwent anatomical resection (p = 0.005) or nonanatomical resection (p = 0.006). For patients with microvascular invasion, anatomical resection combined with a resection margin ≥1 cm provided the longest recurrence-free survival time compared with other treatments (p = 0.001). Anatomical resection was not necessary for patients without microvascular invasion. However, for patients with microvascular invasion, both anatomical resection and a resection margin ≥1 cm were necessary.
本研究旨在确定解剖性肝切除术是否对早期肝细胞癌有必要。采用对数秩检验或两阶段检验进行单因素分析。采用 Cox 比例风险模型进行多因素分析。对于无微血管侵犯的患者，无论行解剖性肝切除术（p = 0.005）还是非解剖性肝切除术（p = 0.006），切缘≥1 cm 提供了最长的无复发生存时间。对于有微血管侵犯的患者，与其他治疗方法相比，解剖性肝切除联合切缘≥1 cm 提供了最长的无复发生存时间（p = 0.001）。对于无微血管侵犯的患者，解剖性肝切除术并非必要。然而，对于有微血管侵犯的患者，解剖性肝切除和切缘≥1 cm 均是必要的。
