Division of General Surgery, Department of Surgery, Keelung Chang Gung Memorial Hospital, No. 222, Maijin Rd., Anle Dist, Keelung City, 204201, Taiwan.
Division of General Surgery, Department of Surgery, Wan Fang Hospital, Taipei Medical University, No.111 Sec.3, Xinglong Rd., Wenshan Dist, Taipei City, 116, Taiwan.
BMC Surg. 2023 Apr 11;23(1):83. doi: 10.1186/s12893-023-01983-y.
Chronic kidney disease (CKD) has been considered to be a poor prognostic factor for hepatocellular carcinoma (HCC). However, few studies have focused on early HCC and the impact of CKD on survival, which should be considered in curative treatment for early HCC.
Patients with BCLC stage 0/A were enrolled from 2009 to 2019. A total of 383 patients were divided into Control group and CKD group, based on estimated glomerular filtration rate. Overall survival (OS) and disease-free survival (DFS) of different treatments were determined using the Kaplan-Meier method.
The Control group had a significantly better OS than the CKD group (72.6 months vs. 56.7 months; p = 0.003). DFS was similar between the groups (62.2 months vs. 63.8 months, p = 0.717). In the Control group, the surgically treated (OP) group had significantly superior OS (65.0 months vs. 80.0 months, p = 0.014) and DFS (50.9 months vs. 70.2 months, p = 0.020) than the radiofrequency ablation-treated group. In the CKD group, the OP group showed a survival advantage in OS (70.6 months vs. 49.2 months, p = 0.004), while DFS was similar between treatment groups (56.0 months vs. 62.2 months, p = 0.097).
CKD should not be considered to be a poor prognostic factor in early HCC patients. Moreover, hepatectomy should be carried out in CKD patient with early HCC for better prognosis if feasible.
慢性肾脏病（CKD）被认为是肝细胞癌（HCC）的预后不良因素。然而，很少有研究关注早期 HCC 以及 CKD 对生存的影响，这在早期 HCC 的治愈性治疗中应予以考虑。
纳入 2009 年至 2019 年 BCLC 分期为 0/A 的患者。根据估算肾小球滤过率，将 383 例患者分为对照组和 CKD 组。采用 Kaplan-Meier 法确定不同治疗方法的总生存期（OS）和无病生存期（DFS）。
对照组的 OS 明显优于 CKD 组（72.6 个月比 56.7 个月；p=0.003）。两组的 DFS 无显著差异（62.2 个月比 63.8 个月，p=0.717）。在对照组中，手术治疗（OP）组的 OS（65.0 个月比 80.0 个月，p=0.014）和 DFS（50.9 个月比 70.2 个月，p=0.020）明显优于射频消融治疗组。在 CKD 组中，OP 组的 OS 生存优势明显（70.6 个月比 49.2 个月，p=0.004），而两组的 DFS 无显著差异（56.0 个月比 62.2 个月，p=0.097）。
CKD 不应被视为早期 HCC 患者的预后不良因素。此外，如果可行，CKD 患者应进行早期 HCC 的肝切除术以获得更好的预后。
