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肿瘤部位是肝切除术后肝细胞癌的一个风险因素:1:2倾向评分匹配分析

Tumour site is a risk factor for hepatocellular carcinoma after hepatectomy: a 1:2 propensity score matching analysis.

作者信息

Li Lian, Xu Liangliang, Zhou Siqi, Wang Peng, Zhang Ming, Li Bo

机构信息

Department of Liver Surgery, West China Hospital, Sichuan University, No. 37 Guo Xue Xiang, Chengdu, 610041, Sichuan Province, China.

出版信息

BMC Surg. 2022 Mar 21;22(1):104. doi: 10.1186/s12893-022-01564-5.

Abstract

BACKGROUND

The effect of the anatomic location of HCC on the prognosis of patients after hepatectomy is currently unclear.

METHODS

Patients who underwent hepatectomy were retrospectively enrolled and divided into the right tumour resection group (R group) and the left tumour resection group (L group) according to the tumour anatomic location. To avoid bias, 1:2 propensity score matching (PSM) analysis was used. Based on the survival data, disease-free survival (DFS) and overall survival (OS) were evaluated by the Kaplan-Meier method, and long-term survival analysis was performed. Cox proportional hazards regression was used to analyse the risk factors associated with postoperative prognosis.

RESULTS

A total of 700 patients were enrolled in our study. After 1:2 PSM, 354 and 177 patients were enrolled in the R group and the L group, respectively, with comparable baseline characteristics. Survival analysis showed that patients in the L group had a significantly higher recurrence rate than patients in the R group (P = 0.036), but there was no significant difference in the survival rate (P = 0.99). Long-term survival analysis showed that the survival rate of the L group was lower than that of the R group (P < 0.01). Multivariate analysis showed that tumour location in the left liver was an independent risk factor for tumour recurrence (hazard ratio, 1.263; 95% CI, 1.005-1.587) and long-term survival (hazard ratio, 3.232; 95% CI, 1.284-8.134).

CONCLUSION

For HCC patients, the recurrence rate and long-term survival rate of left liver tumours were significantly higher than those of right liver tumours, indicating that the anatomical location of the tumour has a significant effect on the survival of HCC patients. Trial registration Chinese Clinical Trial Registry, ChiCTR2100052407. Registered 25 October 2021, http://www.chictr.org.cn/showproj.aspx?proj=135500 .

摘要

背景

目前尚不清楚肝癌(HCC)的解剖位置对肝切除术后患者预后的影响。

方法

回顾性纳入接受肝切除术的患者,并根据肿瘤的解剖位置将其分为右肝肿瘤切除组(R组)和左肝肿瘤切除组(L组)。为避免偏差,采用1:2倾向评分匹配(PSM)分析。基于生存数据,采用Kaplan-Meier法评估无病生存期(DFS)和总生存期(OS),并进行长期生存分析。采用Cox比例风险回归分析与术后预后相关的危险因素。

结果

本研究共纳入700例患者。经过1:2 PSM后,R组和L组分别纳入354例和177例患者,两组基线特征具有可比性。生存分析显示,L组患者的复发率显著高于R组患者(P = 0.036),但生存率无显著差异(P = 0.99)。长期生存分析显示,L组的生存率低于R组(P < 0.01)。多因素分析显示,左肝肿瘤位置是肿瘤复发(风险比,1.263;95%可信区间,1.005 - 1.587)和长期生存(风险比,3.232;95%可信区间,1.284 - 8.134)的独立危险因素。

结论

对于肝癌患者,左肝肿瘤的复发率和长期生存率显著高于右肝肿瘤,表明肿瘤的解剖位置对肝癌患者的生存有显著影响。试验注册 中国临床试验注册中心,ChiCTR2100052407。于2021年10月25日注册,http://www.chictr.org.cn/showproj.aspx?proj=135500

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ba14/8935716/6db6b32d9a79/12893_2022_1564_Fig1_HTML.jpg

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