手术治疗不同大小乙型肝炎病毒相关肝细胞癌的疗效及预后

StephenW

Efficacy of surgical treatment on different sizes of hepatitis B virus-related hepatocellular carcinoma and prognostic analysis
Jiepeng Jia  1 , Jijun Zhang, Quan Shao, Yingkai Wang, Bo Qian, Tao Hu, Wen Zhang
Affiliations
Affiliation

    1
    Department of General Surgery, Sixth Hospital of Shanxi Medical University, Taiyuan 030008, China.

    PMID: 33099926

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Abstract

Purpose: To investigate the efficacy of surgical resection for patients with different sizes of hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC), and to analyze the risk factors influencing the prognosis.

Methods: The clinical data of a total of 138 patients with HBV-related HCC admitted to and treated in our hospital from June 2012 to June 2014 were retrospectively analyzed, and the patients were divided into small HCC (SHCC) group (tumor diameter ≤5 cm, n=69) and solitary large HCC (SLHCC) group (tumor diameter >5 cm, n=69) based on the size of tumors. The differences in operative methods, operation time, intraoperative blood loss, number of intraoperative blood transfusion, time of portal triad clamping and incidence of complications, as well as postoperative liver function and alpha fetoprotein (AFP) indexes, tumor recurrence and survival conditions were compared between the two groups.

Results: Among the 138 HCC patients who underwent hepatectomy, 54 cases had ≥3 resected hepatic segments, and 84 cases had <3 resected hepatic segments. SHCC group exhibited remarkably shorter operation time and notably smaller intraoperative blood loss than SLHCC group. The 1-, 3- and 5-year overall survival rates were 91.3%, 87.0%, 71.0%, 60.9%, 58.0% and 46.4%, respectively, and the 1-, 3- and 5-year disease-free survival rates were 71.0%, 63.8%, 47.8%, 44.9%, 37.7% and 30.4%, respectively, in the two groups. The log-rank test showed that the overall survival rate in SHCC group was distinctly higher than that in SLHCC group (p=0.041), and no statistically significant difference in the disease-free survival rate was detected. According to multivariate analysis, HBV deoxyribonucleic acid (DNA) load ≥104 U/mL, tumor diameter >5 cm and positive microvascular invasion were independent risk factors for the patient's prognosis (p<0.05).

Conclusions: SLHCC has a similar disease-free survival rate to SHCC but a lower overall survival rate than SHCC. HBV DNA load ≥104 U/mL, tumor diameter >5 cm and positive microvascular invasion are independent risk factors for the patient's prognosis.

StephenW

手术治疗不同大小乙型肝炎病毒相关肝细胞癌的疗效及预后分析
贾杰鹏1，张继军，邵泉，王英凯，钱波，胡涛，张雯
隶属关系
联系

    1个
    山西医科大学第六医院普外科，太原030008。

    PMID：33099926

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抽象

目的：探讨手术切除术对不同大小的乙型肝炎病毒（HBV）相关性肝细胞癌（HCC）患者的疗效，并分析影响预后的危险因素。

方法：回顾性分析我院2012年6月至2014年6月收治的138例HBV相关性HCC患者的临床资料，将其分为小肝癌（SHCC）组（肿瘤直径≤5）。 cm，n = 69）和单独的大型HCC（SLHCC）组（肿瘤直径> 5 cm，n = 69），具体取决于肿瘤的大小。比较手术方法，手术时间，术中失血量，术中输血次数，门脉三联症钳夹时间和并发症发生率以及术后肝功能和甲胎蛋白（AFP）指标，肿瘤复发和生存条件的差异。两组之间。

结果：在138例接受肝切除的HCC患者中，有54例切除了≥3个肝段，有84例切除了＜3个肝段。与SLHCC组相比，SHCC组的手术时间明显缩短，术中失血量明显减少。 1年，3年和5年总生存率分别为91.3％，87.0％，71.0％，60.9％，58.0％和46.4％，以及1年，3年和5年无病生存率两组分别为71.0％，63.8％，47.8％，44.9％，37.7％和30.4％。对数秩检验表明，SHCC组的总生存率明显高于SLHCC组（p = 0.041），并且无病生存率没​​有统计学上的显着差异。根据多变量分析，HBV脱氧核糖核酸（DNA）负荷≥104U / mL，肿瘤直径> 5 cm和微血管浸润阳性是患者预后的独立危险因素（p <0.05）。

结论：SLHCC的无病生存率与SHCC相似，但总生存率低于SHCC。 HBV DNA负荷≥104U / mL，肿瘤直径> 5 cm和微血管侵犯为患者预后的独立危险因素。