肝切除术后五年无复发的肝细胞癌患者长期生存结局的预测因素

Predictors of long-term survival outcomes of patients with hepatocellular carcinoma without recurrence at five years after liver resection.

作者信息

Hsieh Cheng-Ying, Yong Chee-Chien, Liu Yueh-Wei, Li Wei-Feng, Wang Chih-Chi, Yen Yi-Hao, Lin Chih-Yun

机构信息

Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan.

Liver Transplantation Center and Department of Surgery, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, 123 Ta Pei Road, Kaohsiung, Taiwan.

出版信息

Langenbecks Arch Surg. 2025 Jun 9;410(1):182. doi: 10.1007/s00423-025-03766-w.

DOI:10.1007/s00423-025-03766-w

PMID:40488766

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12148983/

Abstract

PURPOSE

Hepatocellular carcinoma (HCC) is an aggressive tumor. Few studies have reported predictors of long-term survival of patients without recurrence at five years after liver resection (LR).

METHODS

We consecutively included 1133 patients with HCC undergoing LR. We excluded patients who developed recurrence or died within five years after LR (n = 639) and patients who were recurrence-free within a follow-up period of < 5 years (n = 243). The remaining 251 patients who were without recurrence at five years after LR were included in this study.

RESULTS

Sixty (23.9%) patients developed recurrence during the follow-up period, of whom, 51 (85%) showed recurrence within Milan criteria and 43 (71.7%) underwent curative treatments. Overall survival (OS) was not significantly different between patients with and those without recurrence (p = 0.63). The 10-year OS of the cohort was 78%; 10-year recurrence-free survival (RFS) was 68%. Multivariate analysis showed that MELD score per one increase (HR = 1.058; 95% CI = 1.005-1.115; p = 0.033) and age > 65 years (HR = 2.997; 95% CI = 1.543-5.820; p = 0.001) were associated with mortality, whereas no baseline variable was associated with recurrence.

CONCLUSIONS

Older age and higher MELD score were associated with mortality but no baseline variable was associated with recurrence in this cohort.

摘要

目的

肝细胞癌（HCC）是一种侵袭性肿瘤。很少有研究报道肝切除（LR）术后五年无复发患者的长期生存预测因素。

方法

我们连续纳入了1133例行LR的HCC患者。我们排除了LR术后五年内出现复发或死亡的患者（n = 639）以及随访期<5年无复发的患者（n = 243）。本研究纳入了其余251例LR术后五年无复发的患者。

结果

60例（23.9%）患者在随访期间出现复发，其中51例（85%）复发符合米兰标准，43例（71.7%）接受了根治性治疗。复发患者和未复发患者的总生存期（OS）无显著差异（p = 0.63）。该队列的10年OS为78%；10年无复发生存期（RFS）为68%。多因素分析显示，MELD评分每增加1分（HR = 1.058；95%CI = 1.005 - 1.115；p = 0.033）和年龄>65岁（HR = 2.997；95%CI = 1.543 - 5.820；p = 0.001）与死亡率相关，而没有基线变量与复发相关。