Cancer. 1994 Nov 15;74(10):2772-80. doi: 10.1002/1097-0142(19941115)74:10<2772::aid-cncr2820741006>3.0.co;2-v.
Great progress in the diagnosis and surgical treatment of hepatocellular carcinoma (HCC) has led to an increased number of resectable cases. Much attention has been paid to the factors affecting long term survival of patients with HCC after partial hepatectomy.
Survival rates for approximately 5800 patients with HCC registered by the Liver Cancer Study Group of Japan who received partial hepatic resection from January 1, 1982 to December 31, 1989 were calculated relative to 14 clinicopathologic variables. Cox's multivariate analysis and the stepwise method then were performed to determine significant prognostic variables and to investigate the appropriate combination of these variables for predicting prognosis.
The use of Cox's multivariate proportional hazard model indicated that significant prognostic indicators were alpha-fetoprotein level, tumor size, number of tumors, accompanying cirrhosis, age, surgical curability, and portal involvement. The stepwise method showed that the most valuable prognostic factor was portal involvement, followed by number of tumors, alpha-fetoprotein level, tumor size, accompanying cirrhosis, age, and surgical curability. Furthermore, it was found that the best predictive combination of two factors was number of tumors and alpha-fetoprotein level and that the best predictive combination of three factors was the alpha-fetoprotein level, tumor size, and number of tumors.
This extensive analysis provides information that can be used to predict the prognosis of patients with HCC after undergoing partial hepatectomy.
肝细胞癌（HCC）的诊断和外科治疗取得了巨大进展，可切除病例数量有所增加。部分肝切除术后影响HCC患者长期生存的因素受到了广泛关注。
计算了1982年1月1日至1989年12月31日期间日本肝癌研究组登记的约5800例接受部分肝切除术的HCC患者相对于14个临床病理变量的生存率。然后采用Cox多变量分析和逐步法确定显著的预后变量，并研究这些变量预测预后的适当组合。
Cox多变量比例风险模型的应用表明，显著的预后指标是甲胎蛋白水平、肿瘤大小、肿瘤数量、伴发肝硬化、年龄、手术可治愈性和门静脉受累情况。逐步法显示，最有价值的预后因素是门静脉受累，其次是肿瘤数量、甲胎蛋白水平、肿瘤大小、伴发肝硬化、年龄和手术可治愈性。此外，发现两个因素的最佳预测组合是肿瘤数量和甲胎蛋白水平，三个因素的最佳预测组合是甲胎蛋白水平、肿瘤大小和肿瘤数量。
这项广泛的分析提供了可用于预测部分肝切除术后HCC患者预后的信息。
