定期监测下诊断为肝细胞癌患者的预后：对监测目标的潜在

StephenW

Prognosis of hepatocellular carcinoma patients diagnosed under regular surveillance: potential implications for surveillance goal
Joo Hye SongORCID Icon, Myung Ji Goh, Yewan Park, Joo Hyun OhORCID Icon, Wonseok KangORCID Icon, Dong Hyun Sinn, show all
Pages 274-280 | Received 27 Oct 2020, Accepted 12 Dec 2020, Published online: 05 Jan 2021

    Download citation https://doi.org/10.1080/00365521.2020.1866063 CrossMark Logo CrossMark

Abstract
Aims

The goal of hepatocellular carcinoma (HCC) surveillance is to diagnose cancer at an early stage when treatment is likely to provide the best outcome and thereby, reduce mortality. However, no specific criteria define the ‘early stage’ for tumors diagnosed under HCC surveillance. We aimed to analyze factors that determined the outcome of HCC patients diagnosed under regular surveillance, to find out how early it is necessary to detect tumors during surveillance.
Methods

A retrospective cohort of 874 HCC patients with preserved liver function (Child-Pugh A) who were diagnosed under regular HCC surveillance at Samsung Medical Center from 2014 to 2016 and did not receive liver transplantation as an initial treatment were analyzed. The primary outcome was overall survival (OS).
Results

Tumor size, presence of vascular invasion, albumin-bilirubin grade, and initial treatment modality were independent factors for OS in multivariable analysis. When categorized according to the tumor size, the risk of mortality increased for tumors of > 3 cm, while tumors of 2–3 cm showed similar mortality risks as tumors of ≤2 cm. When categorized according to the tumor factors, curative-intent treatment (resection or ablation) can be applied to 84.5% with excellent outcomes (5-year OS rate, 93.4%), for tumors of ≤3 cm without vascular invasion.
Conclusions

When tumors of ≤3 cm were detected and had no vascular invasion, curative-intent treatment was applied for most patients and showed excellent OS. This finding suggests that to detect tumors of <3 cm without vascular invasion may be considered as the goal of HCC surveillance.

Keywords: Chronic hepatitishepatocellular carcinomatumor burdenearly detection of cancersurvival rate

StephenW

定期监测下诊断为肝细胞癌患者的预后：对监测目标的潜在影响
Joo Hye SongORCID图标，Myung Ji Goh，Yewan Park，Joo Hyun OhORCID图标，Wonseok KangORCID图标，Dong Hyun Sinn，显示全部
第274-280页|于2020年10月27日收到，于2020年12月12日接受，在线发布：2021年1月5日

    下载引文https://doi.org/10.1080/00365521.2020.1866063 CrossMark徽标CrossMark

抽象的
目的

肝细胞癌（HCC）监视的目标是在治疗可能提供最佳结果从而降低死亡率的早期阶段诊断癌症。但是，尚无特定标准定义在HCC监测下诊断出的肿瘤的“早期”阶段。我们旨在分析确定在常规监测下诊断出的HCC患者的结局的因素，以找出在监测过程中发现肿瘤的必要时间。
方法

分析了2014年至2016年在三星医疗中心接受定期HCC监测诊断且未接受肝移植作为初始治疗的874例肝功能保留的HCC患者（Child-Pugh A）的回顾性研究。主要结果是总体生存期（OS）。
结果

肿瘤大小，是否存在血管浸润，白蛋白-胆红素等级和初始治疗方式是多变量分析中OS的独立因素。按肿瘤大小分类时，> 3 cm的肿瘤的死亡风险增加，而2–3 cm的肿瘤与≤2cm的肿瘤具有相似的死亡风险。根据肿瘤因素进行分类时，对于≤3cm且无血管浸润的肿瘤，可以进行根治性治疗（切除或消融）达到84.5％，具有极好的结果（5年OS率，93.4％）。
结论

当检测到≤3cm的肿瘤且无血管浸润时，大多数患者均进行了根治性治疗，并显示出良好的OS。这一发现表明，在不引起血管侵犯的情况下检测<3 cm的肿瘤可能被视为肝癌监测的目标。

关键词：慢性肝炎肝细胞癌肿瘤早期检测生存率