消融和切除术后肝细胞癌患者的早期复发：倾向评分分析。

Early recurrence of hepatocellular carcinoma in patients after ablation and resection: A propensity score analysis.

机构信息

State Key Laboratory of Oncology in South China, Sun Yat-Sen University Cancer Center, Guangzhou, China; Department of Hepatobiliary Oncology, Sun Yat-Sen University Cancer Center, Guangzhou, China.

出版信息

Am J Surg. 2024 Feb;228:94-101. doi: 10.1016/j.amjsurg.2023.08.002. Epub 2023 Aug 3.

DOI:10.1016/j.amjsurg.2023.08.002

PMID:37580221

Abstract

BACKGROUND

Early recurrence (ER, recurrence within 2 years) is common in hepatocellular carcinoma (HCC) patients after ablation and resection. We aimed to compare ER and assess the associated risk factors.

METHODS

We collected data from patients underwent resection (1,235) or ablation (517) for early HCC (solitary tumor ≤5 cm). Baseline of patients were matched using propensity score matching.

RESULTS

In the matched cohort of 690 patients, the ablation group had a higher ER rate (37.4% vs. 19.4%; P < .001) than the resection group. Patients with ER had worse overall survival (OS) than those without ER in both the ablation (5-year OS: 60.4% vs. 86.7%) and resection groups (5-year OS: 59.2% vs. 88.1%). Ablation treatment was identified as an independent adverse prognostic factor for ER (hazard ratio: 2.751, P < .001). Resection conferred a significant favorable OS than ablation (2-year: 95.4% vs. 90.9%; 5-years: 83.8% vs. 77.0%).

CONCLUSIONS

Resection was superior to ablation in minimizing the risk of ER and offering a better OS for patients with early HCC.

摘要

背景

肝癌患者经消融和切除术治疗后，早期复发（ER，2 年内复发）较为常见。本研究旨在比较 ER 并评估其相关的危险因素。

方法

我们收集了接受根治性切除术（1,235 例）或消融术（517 例）治疗的早期 HCC（单发肿瘤≤5cm）患者的数据。采用倾向评分匹配法对患者的基线数据进行匹配。

结果

在 690 例匹配患者中，消融组的 ER 发生率（37.4% vs. 19.4%；P<0.001）高于切除术组。在消融组（5 年 OS：60.4% vs. 86.7%）和切除术组（5 年 OS：59.2% vs. 88.1%）中，发生 ER 的患者总生存（OS）均差于未发生 ER 的患者。消融治疗是 ER 的独立不良预后因素（风险比：2.751，P<0.001）。与消融相比，切除术提供了更好的 OS（2 年：95.4% vs. 90.9%；5 年：83.8% vs. 77.0%）。