Yen Yi-Hao, Moi Sin-Hua, Liu Yueh-Wei, Yong Chee-Chien, Wang Chih-Chi, Li Wei-Feng, Lin Chih-Yun
Division of Hepatogastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, 123 Ta Pei Road, Kaohsiung, Taiwan.
Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
Updates Surg. 2025 May 13. doi: 10.1007/s13304-025-02226-w.
Conditional survival (CS) is a measure of prognosis of patients who have already survived several years since diagnosis. However, few studies have investigated the CS of patients who underwent liver resection (LR) for early-stage hepatocellular carcinoma (HCC). We enrolled 942 consecutive patients who underwent LR for HCC with pathology-defined American Joint Committee on Cancer (AJCC) 7th edition stage 1 or 2 disease. The three-year CS was calculated as CS = S(x + 3)/S(x) and represented the probability of surviving an additional three years, given that the patient had already survived x years. The one-, three-, and five-year survival rates were 97.1%, 86.7%, and 76.1%, respectively, and were lower in cases with AJCC stage 2 disease, alpha-fetoprotein level of ≥ 20 ng/ml, presence of cirrhosis, anti-hepatitis C virus positivity, age > 65 years, and Model for End-Stage Liver Disease score of > 9. However, the three-year CS indicated that these variables were associated with shortened survival only in the first two years. From the third year after LR, the probability of survival of patients was similar between subgroups. CS is useful for providing a dynamic evaluation of survival during postoperative follow-up.
条件生存（CS）是对自诊断后已存活数年的患者预后的一种衡量指标。然而，很少有研究调查接受肝切除术（LR）治疗早期肝细胞癌（HCC）患者的CS情况。我们纳入了942例连续接受LR治疗的HCC患者，其病理诊断为美国癌症联合委员会（AJCC）第7版分期1或2期疾病。三年CS计算为CS = S(x + 3)/S(x)，表示患者已存活x年的情况下再存活三年的概率。1年、3年和5年生存率分别为97.1%、86.7%和76.1%，在AJCC 2期疾病、甲胎蛋白水平≥20 ng/ml、存在肝硬化、抗丙型肝炎病毒阳性、年龄>65岁以及终末期肝病模型评分>9的病例中较低。然而，三年CS表明这些变量仅在前两年与生存缩短相关。从LR后的第三年起，各亚组患者的生存概率相似。CS有助于在术后随访期间对生存情况进行动态评估。
