在现代抗病毒治疗时代，肿瘤大小不影响接受单一肝细胞癌切除术且无微观血管侵犯患者的生存结局。
Tumor Size Does Not Affect Survival Outcomes of Patients Undergoing Resection for a Single Hepatocellular Carcinoma Without Microscopic Vascular Invasion in the Modern Era of Antiviral Therapy.
作者信息
Yen Yi-Hao, Kuo Fang-Ying, Eng Hock-Liew, Liu Yueh-Wei, Yong Chee-Chien, Wang Chih-Chi, Li Wei-Feng, Lin Chih-Yun
机构信息
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.
Department of Pathology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
出版信息
Dig Dis Sci. 2025 Jul 24. doi: 10.1007/s10620-025-09254-x.
PURPOSE
Whether tumor size affects the survival of patients undergoing liver resection (LR) for a single hepatocellular carcinoma (HCC) without microscopic vascular invasion (MVI), i.e., pathological T1N0M0, is controversial.
METHODS
We enrolled 626 patients with HCC of pathological stage T1N0M0 of the 7th edition of American Joint Committee on Cancer staging who underwent LR between 2011 and 2021 at our institution. The overall survival (OS) and recurrence-free survival (RFS) of patients with T1N0M0 HCC > 5.0 cm and those with T1N0M0 HCC ≤ 5.0 cm was compared using the Kaplan-Meier estimator and log-rank test both before and after propensity score matching (PSM).
RESULTS
Ninety-two (14.7%) patients had T1N0M0 HCC > 5.0 cm. The proportion of patients with cirrhosis was lower in the T1N0M0 HCC > 5.0 cm group than in the T1N0M0 HCC ≤ 5.0 cm group (16.3 vs 41.2%, p < 0.001). Five-year OS did not differ significantly between the two groups before PSM (82 vs 84%, p = 0.857) or after PSM (84 vs 94%, p = 0.678). Five-year RFS did not differ significantly between the two groups before PSM (63 vs. 66%, p = 0.778) or after PSM (65 vs. 65%, p = 0.371).
CONCLUSION
Tumor size did not affect the survival outcomes of patients undergoing LR for T1N0M0 HCC.
目的
肿瘤大小是否会影响无微观血管侵犯（MVI），即病理分期为T1N0M0的单发肝细胞癌（HCC）患者接受肝切除术（LR）后的生存情况，这一问题存在争议。
方法
我们纳入了626例美国癌症联合委员会第7版癌症分期中病理分期为T1N0M0的HCC患者，这些患者于2011年至2021年在我们机构接受了LR。使用Kaplan-Meier估计法和对数秩检验比较了肿瘤大小＞5.0 cm的T1N0M0 HCC患者与肿瘤大小≤5.0 cm的T1N0M0 HCC患者在倾向评分匹配（PSM）前后的总生存期（OS）和无复发生存期（RFS）。
结果
92例（14.7%）患者的肿瘤大小＞5.0 cm。肿瘤大小＞5.0 cm的T1N0M0 HCC患者中肝硬化患者的比例低于肿瘤大小≤5.0 cm的T1N0M0 HCC患者组（16.3%对41.2%，p＜0.001）。PSM前两组的5年总生存率无显著差异（82%对84%，p = 0.857），PSM后也无显著差异（84%对94%，p = 0.678）。PSM前两组的5年无复发生存率无显著差异（63%对66%，p = 0.778），PSM后也无显著差异（65%对65%，p = 0.371）。
结论
肿瘤大小不影响T1N0M0 HCC患者接受LR后的生存结局。
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