PROGNOSTIC FACTORS OF HEPATOCELLULAR-CARCINOMA IN THE WEST - A MULTIVARIATE-ANALYSIS IN 206 PATIENTS
PROGNOSTIC FACTORS OF HEPATOCELLULAR-CARCINOMA IN THE WEST - A MULTIVARIATE-ANALYSIS IN 206 PATIENTS
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DOI：
10.1002/hep.1840120422
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发表时间：
1990-10-01
期刊：
影响因子：
13.5
通讯作者：
RODES, J
中科院分区：
文献类型：
--
作者：
CALVET, X;BRUIX, J;RODES, J
为了探讨影响西方肝癌患者预后的因素，我们对206例确诊为肝癌的患者的生存情况进行了研究。所有患者都是在1983年至1987年间确诊的。多变量生存分析（Cox回归模型）利用诊断时获得的临床、生化、超声和病理数据显示，胆红素（p = 0.0001）、腹水（p = 0.0001）、中毒综合征（以体重减轻bbb10 %为定义，不适和厌食）（p = 0.009）、血尿素氮（p = 0.025）、肿瘤大小（p = 0.001）、。-谷氨酰转肽酶（p = 0.0006）、年龄（p = 0.0005）、血清钠（p = 0.003）和是否存在转移（p = 0.002）是生存的独立预测因素。根据这些因素对最终模型的贡献，构建了一个预后指数，允许根据患者的相对死亡风险将患者分为不同的组：RRD = EXP（年龄.次）。0.03 +腹水。0.8281 + BUN .times。0.0137 +血清钠。倍。（-0.0538） +。谷氨酰转肽酶同学。0.0019 +胆红素。0.0734 +肿瘤大小。倍。0.33 +中毒综合征。次。0.4965 +转移。0.55)。这些结果有助于对肝细胞癌患者进行分层，以设计和评估未来的对照试验。
To investigate the prognostic factors in Western patients with hepatocellular carcinoma, 206 patients with confirmed diagnoses of hepatocellular carcinoma were studied in terms of survival. All patients were diagnosed between 1983 and 1987. A multivariate survival analysis (Cox regression model) using clinical, biochemical, ultrasonographical and pathological data obtained at diagnosis disclosed that bilirubin (p = 0.0001), ascites (p = 0.0001), toxic syndrome (defined by the presence of weight loss > 10% premorbid weight, malaise and anorexia) (p = 0.009), blood urea nitrogen (p = 0.025), tumor size (p = 0.001), .gamma.-glutamyltranspeptidase (p = 0.0006), age (p = 0.0005), serum sodium (p = 0.003) and presence of metastases (p = 0.002) were independent predictors of survival. According to the contribution of each of these factors to the final model, a prognostic index was constructed allowing division of patients in different groups according to their relative risk of death: RRD = EXP (Age .times. 0.03 + Ascites .times. 0.8281 + BUN .times. 0.0137 + Serum sodium .times. (-0.0538) + .gamma.-Glutamyltranspeptidase .times. 0.0019 + Bilirubin .times. 0.0734 + Tumor size .times. 0.33 + Toxic syndrome .times. 0.4965 + Metastases .times. 0.55). These results facilitate the stratification of hepatocellular carcinoma patients to design and evaluate future controlled trials.