Second Department of Surgery, Dokkyo Medical University, 880 Kitakobayashi, Mibu, Tochigi, 321-0293, Japan.
World J Surg Oncol. 2020 Dec 3;18(1):317. doi: 10.1186/s12957-020-02100-6.
The tumor location is the most simple clinical factor and important in liver surgery to make surgical procedure. However, no previous study has investigated the prognostic differences and clinical features of hepatocellular carcinoma showing specific laterality. This study is the first report to focus on the laterality and aimed to lead to more simple and useful predictive factor rather than recent complicated predictive models.
Patients who underwent liver resection for the first time for single tumors located within each lobe between 2000 and 2018 were enrolled. We divided them into two groups based on tumor location: a right-sided group and a left-sided group. Univariable and multivariable analyses were performed to assess survival differences in relation to several other factors.
There were 595 eligible patients; the 5-year survival rates and disease-free survival rates were 49.5% and 19.1% in the left-sided group and 55.6% and 24.5% in the right-sided group, respectively (p = 0.026). Statistical analyses revealed that the following preoperative prognostic factors were independently significant (p < 0.05) in the left-sided group: indocyanine green retention rate at 15 min, alpha fetoprotein, protein induced by vitamin K absence or antagonists-II level, and larger tumor size.
The left-sided group had a poorer prognosis than the right-sided group. A left-sided tumor location is a significant preoperative factor predictive of poor outcome in patients with hepatocellular carcinoma.
肿瘤位置是肝脏手术中最基本的临床因素，也是最重要的因素。然而，以前的研究并没有调查具有特定侧别的肝细胞癌的预后差异和临床特征。本研究首次关注侧别，并旨在提出更简单、更有用的预测因素，而不是最近复杂的预测模型。
我们纳入了 2000 年至 2018 年间在每个肝叶内首次接受单一肿瘤切除术的患者。我们根据肿瘤位置将其分为两组：右侧组和左侧组。进行单变量和多变量分析，以评估与其他几个因素相关的生存差异。
共纳入 595 例符合条件的患者；左侧组的 5 年生存率和无病生存率分别为 49.5%和 19.1%，右侧组分别为 55.6%和 24.5%（p = 0.026）。统计分析显示，以下术前预后因素在左侧组中具有独立显著性（p < 0.05）：15 分钟吲哚菁绿滞留率、甲胎蛋白、维生素 K 拮抗剂-II 诱导蛋白水平和肿瘤较大。
左侧组的预后比右侧组差。左侧肿瘤位置是肝细胞癌患者预后不良的重要术前因素。
