Optimizing stage of single large hepatocellular carcinoma: A study with subgroup analysis by tumor diameter.
Optimizing stage of single large hepatocellular carcinoma: A study with subgroup analysis by tumor diameter.
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单发大肝癌优化分期：按肿瘤直径进行亚组分析的研究
DOI：
10.1097/md.0000000000006608
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发表时间：
2017-04
期刊：
影响因子：
1.6
通讯作者：
Li LQ
中科院分区：
文献类型：
--
作者：
Zhong JH;Pan LH;Wang YY;Cucchetti A;Yang T;You XM;Ma L;Gong WF;Xiang BD;Peng NF;Wu FX;Li LQ
本研究旨在通过比较这些患者与单发肿瘤≤5 cm患者和B期患者的切除术后预后来完善单发肝细胞癌（HCC）>5 cm的定义。 单肿瘤患者根据直径分为亚组。在分析的1132例患者中，426例患者的单个肿瘤>2 cm且≤5 cm; 229例患者的单个肿瘤>5 cm且≤8 cm; 52例患者的单个肿瘤>8 cm且<10 cm; 150例患者的单个肿瘤≥10 cm; 275例患者的分期为B期。 在单肿瘤亚组中，住院死亡率和并发症随肿瘤大小增加而增加，中位生存期随肿瘤大小增加而降低。单个肿瘤>5 cm患者的总生存期（OS）显著低于单个肿瘤>2 cm和≤5 cm患者（P ≤.001），但显著高于明确分期为B的患者（P ≤.001）。 单个肿瘤>5 cm且≤8 cm的患者的OS低于单个肿瘤>2 cm且≤5 cm的患者（P <.001）。 单个肿瘤>8 cm且<10 cm或单个肿瘤≥10 cm的患者的OS低于单个肿瘤>5 cm且≤8 cm的患者（P = 0.033和0.006），与B期患者的OS相似（P = 0.323）。 单个肿瘤>5且≤8 cm的患者可被分配到早期和中期之间的新阶段。 单个肿瘤>8 cm的患者可被分配到中间阶段。
This study aims to refine the designation for single hepatocellular carcinoma (HCC) >5 cm by comparing the postresection prognosis of these patients with those who have a single-tumor ≤5 cm and those with stage B. Patients with a single-tumor were classified into subgroups based on diameter. Of the 1132 patients analyzed, 426 had a single-tumor >2 and ≤5 cm; 229, a single-tumor >5 and ≤8 cm; 52, a single-tumor >8 and < 10 cm; 150, a single-tumor ≥10 cm; and 275, stage B. Hospital mortality and complications increased with tumor size among the single-tumor subgroups and median survival decreased with increasing of tumor size. Overall survival (OS) among patients with a single-tumor >5 cm was significantly lower than among patients with a single-tumor >2 and ≤5 cm (P ≤ .001), but significantly higher than among patients with clearly stage B (P ≤ .001). Patients with a single-tumor >5 and ≤8 cm showed lower OS than patients with a single-tumor >2 and ≤5 cm (P < .001). Patients with a single-tumor >8 and <10 cm or a single-tumor ≥10 cm showed lower OS than patients with a single-tumor >5 and ≤8 cm (P = .033 and .006), and similar OS to patients with stage B (P = .323). Patients with a single-tumor >5 and ≤8 cm may be assigned to a new stage between early and intermediate. Patients with a single-tumor >8 cm may be assigned to intermediate stage.