Risk Factors for Early and Late Intrahepatic Recurrence in Patients with Single Hepatocellular Carcinoma Without Macrovascular Invasion after Curative Resection
Risk Factors for Early and Late Intrahepatic Recurrence in Patients with Single Hepatocellular Carcinoma Without Macrovascular Invasion after Curative Resection
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无大血管侵犯的单发性肝细胞癌根治性切除术后早期和晚期肝内复发的危险因素。
DOI：
10.7314/apjcp.2013.14.8.4759
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发表时间：
2013-01-01
影响因子：
--
通讯作者：
Guo, Rong-Ping
中科院分区：
文献类型：
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作者：
Li, Shu-Hong;Guo, Zhi-Xing;Guo, Rong-Ping
背景：接受根治性切除的肝细胞癌（HCC）患者术后早期和晚期复发的预后因素仍有待阐明。本研究的目的是确定无大血管侵犯的单发 HCC 患者术后早期（2 年）肝内复发的危险因素。方法：回顾性纳入2004年12月至2007年12月期间280例患者。肝内复发分为早期（2年），并进行卡方检验或Fisher精确检验以及多因素logistic回归分析以确定显着的危险因素。结果：随访期间，124例患者出现肝内复发，其中早期82例，晚期42例。多因素logistic回归分析显示，微血管侵犯（p=0.006，HR：2.397，95％CI：1.290-4.451）是女性（p=0.031，HR：0.326，95％CI：0.118-0.901）且肝硬化程度较高的早期复发的唯一独立危险因素。 (P=0.001，HR：2.483，95% CI：1.417-4.349)是晚期复发的独立危险因素。结论：无大血管侵犯的单发 HCC 患者的早期和晚期复发与不同危险因素相关。这一结果表明，预防根治性切除术后复发的策略有不同的侧重点，对于有相关危险因素的患者，需要更积极的干预，包括辅助治疗、抗肝硬化药物和仔细的随访。
Background: Prognostic factors of postoperative early and late recurrence in patients with hepatocellular carcinoma (HCC)undergoing curative resection remain to be clarified. The aim of this study was to identify risk factors for postoperative early ( 2 year)intrahepatic recurrences in patients with single HCCs without macrovascular invasion. Methods: A total of 280 patients from December 2004 to December 2007 were retrospectively included in this study. Intrahepatic recurrence was classified into early ( 2 year)and the Chi-Square test or Fisher's exact test and multivariate logistic regression analysis were performed to determine significant risk factors. Results: During the follow-up, 124 patients had intrahepatic recurrence, early and late in 82 and 42 patients, respectively. Multivariate logistic regression analysis showed that microvascular invasion (p=0.006, HR: 2.397, 95% CI: 1.290-4.451)was the only independent risk factor for early recurrence, while being female (p = 0.031, HR: 0.326, 95% CI: 0.118-0.901), and having a high degree of cirrhosis (P=0.001, HR: 2.483, 95% CI: 1.417-4.349)were independent risk factors for late recurrence. Conclusions: Early and late recurrence of HCC is linked to different risk factors in patients with single HCC without macrovascular invasion. This results suggested different emphases of strategies for prevent of recurrence after curative resection, more active intervention including adjuvant therapy, anti-cirrhosis drugs and careful follow-up being necessary for patients with relevant risk factors.