Li Pengpeng, Wang Mengchao, Yang Yuan, Liu Hui, Pan Zeya, Jiang Beige, Lau Wan Yee, Huang Gang, Zhou Weiping
Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai 200438, China.
Faculty of Medicine, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong, China.
Ann Transl Med. 2020 Mar;8(5):182. doi: 10.21037/atm.2020.01.106.
Compared with 2D evaluation, 3D evaluation possesses the virtues of displaying spatial anatomy of intrahepatic blood vessels and its relations to tumors, and enabling calculation of liver volumes, thus facilitating preoperative surgery planning.
The objective of this study is to study whether preoperative 3D (three-dimensional) evaluation produced better long-term overall survival (OS) outcomes compared to the traditional 2D (two-dimensional) evaluation in patients who underwent major hepatectomy for hepatocellular carcinoma (HCC). This retrospective study matched patients who underwent preoperative 2D evaluation with those who underwent preoperative 3D evaluation in a 1:1 ratio using propensity score matching. The primary endpoints were long-term survival outcomes in the two groups after major hepatectomy for HCC.
Of the 248 patients in each of the 2 matched groups, the baseline characteristics were comparable. The median follow-up for all patients was 36 months (range, 0-40 months). The 3-year OS of patients in the PSM cohort was 38.5%. Compared with the 2D Group, patients in the 3D Group had a better OS rate (HR 0.722, 95% CI: 0.556-0.938, P=0.015) and disease-free survival (DFS) rate (HR 0.741, 95% CI: 0.590-0.929, P=0.009). The 3-year OS and DFS rate for the 3D Group versus the 2D group were 58.9% and 44.0% versus 47.4% and 33.1%, respectively.
3D preoperative evaluation resulted in significantly better intermediate-term (3-year) overall survival rate than the traditional 2D evaluation.
与二维评估相比，三维评估具有能够显示肝内血管的空间解剖结构及其与肿瘤的关系，并能计算肝脏体积的优点，从而有助于术前手术规划。
本研究的目的是探讨在接受肝细胞癌（HCC）大肝切除术的患者中，术前三维（3D）评估与传统二维（2D）评估相比是否能产生更好的长期总生存（OS）结果。这项回顾性研究使用倾向评分匹配，将接受术前二维评估的患者与接受术前三维评估的患者按1:1的比例进行匹配。主要终点是两组在HCC大肝切除术后的长期生存结果。
在两个匹配组中，每组248例患者的基线特征具有可比性。所有患者的中位随访时间为36个月（范围为0至40个月）。PSM队列中患者的3年总生存率为38.5%。与二维组相比，三维组患者的总生存率（HR 0.722，95%CI：0.556 - 0.938，P = 0.015）和无病生存率（DFS）（HR 0.741，95%CI：0.590 - 0.929，P = 0.009）更高。三维组与二维组的3年总生存率和无病生存率分别为58.9%和44.0%以及47.4%和33.1%。
术前三维评估的中期（3年）总生存率明显优于传统二维评估。
