Liu Yueh-Wei, Li Wei-Feng, Kuo Fang-Ying, Eng Hock-Liew, Wang Chih-Chi, Lin Chih-Che, Yong Chee-Chien, Yen Yi-Hao
Liver Transplantation Center and Department of Surgery, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan.
Department of Pathology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
Langenbecks Arch Surg. 2023 Apr 27;408(1):166. doi: 10.1007/s00423-023-02841-4.
The 8th edition of the American Joint Committee on Cancer (AJCC) staging system for hepatocellular carcinoma (HCC) has been used since 2018. However, whether any significant difference in overall survival (OS) exists between patients with T1a and T1b HCC who undergo resection has been controversial. We aim to clarify this issue.
We consecutively enrolled newly diagnosed HCC patients who underwent liver resection (LR) from 2010 to 2020 at our institution. OS was estimated using the Kaplan-Meier method and compared using log-rank tests. Prognostic factors for OS were identified by multivariate analysis.
This study enrolled 1250 newly diagnosed HCC patients who underwent LR. No significant differences in OS were identified between patients with T1a and T1b tumors among all patients (p = 0.694), cirrhotic patients (p = 0.753), non-cirrhotic patients (p = 0.146), patients with alpha-fetoprotein (AFP) > 20 ng/ml (p = 0.562), patients with AFP ≤ 20 ng/ml (p = 0.967), patients with Edmondson grade 1 or 2 (p = 0.615), patients with Edmondson grade 3 or 4 (p = 0.825), patients positive for hepatitis B surface antigen (HBsAg; p = 0.308), in patients positive for anti-hepatitis C virus (HCV) antibody (p = 0.781), or patients negative for both HBsAg and anti-HCV antibody (p = 0.125). Using T1a as the reference, multivariate analysis showed that T1b is not a significant predictive factor for OS (hazard ratio (HR): 1.338; 95% confidence interval (CI):0.737-2.431; p = 0.339).
No significant difference in OS was observed between patients who underwent LR to treat T1a and T1b HCC tumors.
美国癌症联合委员会（AJCC）第8版肝细胞癌（HCC）分期系统自2018年起开始使用。然而，接受手术切除的T1a期和T1b期HCC患者的总生存期（OS）是否存在显著差异一直存在争议。我们旨在阐明这一问题。
我们连续纳入了2010年至2020年在我院接受肝切除术（LR）的新诊断HCC患者。采用Kaplan-Meier法估计OS，并使用对数秩检验进行比较。通过多因素分析确定OS的预后因素。
本研究纳入了1250例接受LR的新诊断HCC患者。在所有患者（p = 0.694）、肝硬化患者（p = 0.753）、非肝硬化患者（p = 0.146）、甲胎蛋白（AFP）>20 ng/ml的患者（p = 0.562）、AFP≤20 ng/ml的患者（p = 0.967）、Edmondson 1级或2级的患者（p = 0.615）、Edmondson 3级或4级的患者（p = 0.825）、乙肝表面抗原（HBsAg）阳性的患者（p = 0.308）、抗丙型肝炎病毒（HCV）抗体阳性的患者（p = 0.781）或HBsAg和抗HCV抗体均阴性的患者（p = 0.125）中，T1a期和T1b期肿瘤患者的OS均无显著差异。以T1a为参照，多因素分析显示T1b不是OS的显著预测因素（风险比（HR）：1.338；95%置信区间（CI）：0.737 - 2.431；p = 0.339）。
接受LR治疗T1a期和T1b期HCC肿瘤的患者之间未观察到OS有显著差异。
