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不同的风险因素与肝癌根治性切除术后早期和晚期复发有关。

Different Risk Factors for Early and Late Recurrence After Curative Resection of Hepatocellular Carcinoma.

机构信息

Department of Surgery, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, Korea.

Clinical Medical College and The First Affiliated Hospital of Chengdu Medical College, Chengdu, China.

出版信息

World J Surg. 2022 Jan;46(1):197-206. doi: 10.1007/s00268-021-06308-9. Epub 2021 Sep 17.

Abstract

BACKGROUND

Factors of early and late recurrence after curative resection of hepatocellular carcinoma (HCC) may be different. The aim of this study was to identify clinical factors, including liver stiffness measurement (LSM), which are associated with HCC recurrence after curative resection.

METHODS

Patients who underwent preoperative LSM and primary curative resection for HCC between October 2015 and May 2018 were retrospectively reviewed, with 1 year as the cut-off between early and late recurrence.

RESULTS

Recurrence was observed in 42/149 (28.2%) patients over a median follow-up of 38.3 months (early recurrence: 10 [6.7%] patients; late recurrence: 32 [21.5%] patients). Multivariate analysis identified LSM (P = 0.026) and tumor size (P = 0.010) as the only factors that were significantly associated with recurrence-free survival. Compared with patients without recurrence, those with early recurrence had larger tumor size (P = 0.035) and those with late recurrence had higher LSM (P = 0.024). Receiver-operating characteristic analysis indicated that the optimal LSM cut-off value for predicting HCC recurrence was 7.4 kPa.

CONCLUSION

Tumor size was associated with early HCC recurrence after curative resection and LSM was associated with late recurrence. LSM cut-off of 7.4 kPa is recommended in predicting recurrence.

摘要

背景

肝癌(HCC)根治性切除术后早期和晚期复发的因素可能不同。本研究旨在确定与根治性切除术后 HCC 复发相关的临床因素,包括肝硬度测量(LSM)。

方法

回顾性分析 2015 年 10 月至 2018 年 5 月期间接受术前 LSM 和原发性根治性切除 HCC 的患者,以 1 年为早期和晚期复发的时间截点。

结果

在中位随访 38.3 个月期间,42/149(28.2%)例患者发生复发(早期复发:10 [6.7%]例;晚期复发:32 [21.5%]例)。多因素分析确定 LSM(P=0.026)和肿瘤大小(P=0.010)是与无复发生存率显著相关的唯一因素。与无复发患者相比,早期复发患者的肿瘤较大(P=0.035),晚期复发患者的 LSM 较高(P=0.024)。受试者工作特征分析表明,预测 HCC 复发的最佳 LSM 截断值为 7.4kPa。

结论

肿瘤大小与根治性切除术后早期 HCC 复发相关,LSM 与晚期复发相关。建议将 7.4kPa 的 LSM 截断值用于预测复发。

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