Sakai Nozomu, Takayashiki Tsukasa, Takano Shigetsugu, Suzuki Daisuke, Ohtsuka Masayuki
Department of General Surgery, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670, Japan.
Sci Rep. 2024 Dec 28;14(1):31290. doi: 10.1038/s41598-024-82741-9.
Liver function affects the prognosis of patients with hepatocellular carcinoma (HCC). This study aimed to investigate the prognostic impact of the functional liver imaging score (FLIS), assessed using gadoxetic acid-enhanced magnetic resonance imaging, on long-term outcomes following hepatectomy for HCC. The FLIS was assessed in 235 patients who underwent initial hepatectomy for HCC. The relationship between FLIS and prognosis was retrospectively analyzed. The FLIS was 6 in 185, and 2-5 in 50, patients. The 5-year recurrence-free and overall survival rates were 43.6% and 76.4% in patients with an FLIS of 6, and 23.0% and 42.4% in patients with an FLIS of 2-5, respectively; both recurrence-free and overall survival were significantly better in patients with an FLIS of 6 (P = 0.012 and 0.001, respectively). Multivariable analyses revealed that microvascular invasion (hazard ratio: 3.611; P = 0.002) and an FLIS of 2-5 (hazard ratio: 2.558; P = 0.027) were independently associated with shorter overall survival. After propensity-score matching, overall survival was significantly better in patients with an FLIS of 6. A low FLIS was significantly associated with poor prognosis following initial hepatectomy for HCC, suggesting that surgical indications must be carefully considered in patients with a low FLIS.
肝功能影响肝细胞癌（HCC）患者的预后。本研究旨在探讨使用钆塞酸二钠增强磁共振成像评估的功能性肝脏影像评分（FLIS）对HCC肝切除术后长期预后的影响。对235例行初次HCC肝切除术的患者进行了FLIS评估。回顾性分析FLIS与预后的关系。185例患者的FLIS为6分，50例患者的FLIS为2 - 5分。FLIS为6分的患者5年无复发生存率和总生存率分别为43.6%和76.4%，FLIS为2 - 5分的患者分别为23.0%和42.4%；FLIS为6分的患者无复发生存率和总生存率均显著更好（P分别为0.012和0.001）。多变量分析显示，微血管侵犯（风险比：3.611；P = 0.002）和FLIS为2 - 5分（风险比：2.558；P = 0.027）与较短的总生存期独立相关。倾向评分匹配后，FLIS为6分的患者总生存期显著更好。低FLIS与初次HCC肝切除术后的不良预后显著相关，提示对于FLIS低的患者必须仔细考虑手术指征。
