Actual 10-year survival following hepatectomy for hepatocellular carcinoma
Actual 10-year survival following hepatectomy for hepatocellular carcinoma
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DOI：
10.1111/hpb.12206
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发表时间：
2014-09-01
期刊：
影响因子：
2.9
通讯作者：
Roayaie, Sasan
中科院分区：
文献类型：
--
作者：
Franssen, Bernardo;Jibara, Ghalib;Roayaie, Sasan
目的：本研究比较了10年存活者与存活≥ 10年的患者（A组），并与148例未存活的患者（B组）进行了比较。A组肿瘤较小（5.7 cm vs 8.2 cm; P = 0.001），微血管浸润发生率较低（18.5% vs 37.1%; P = 0.004）。复发率无显著差异（A组18/28，64.3%与B组94/148，63.5%）。A组的中位复发时间较长（70个月比15个月; P < 0.0001），并且A组中更多的患者能够接受复发的根治性治疗（88.8%比40.4%; P < 0.0001）。多变量分析显示，无血管侵犯（P = 0.020），无围手术期输血（P = 0.014），原发性切除术后2年以上复发（P = 0.045）与10年生存率显著相关。复发并不妨碍长期生存。切除术后2年以上复发、无血管侵犯和无围手术期输血与10年生存率独立相关。
Objectives: This study was conducted to compare 10-year survivors with patients who survived = 10 years (Group A) and were compared with the 148 patients who did not (Group B). Group A had smaller tumours (5.7 cm versus 8.2 cm; P = 0.001) and a lower incidence of microvascular invasion (18.5% versus 37.1%; P = 0.004). Recurrence did not differ significantly (Group A 18/28, 64.3% versus Group B 94/148, 63.5%). Median time to recurrence was longer in Group A (70 months versus 15 months; P < 0.0001), and more patients in Group A were able to undergo curative treatment for recurrence (88.8% versus 40.4%; P < 0.0001). Multivariate analysis showed that lack of vascular invasion (P = 0.020), absence of perioperative transfusion (P = 0.014), and recurrence at >2 years after primary resection (P = 0.045) were significantly associated with 10-year survival.Conclusions: Ten-year survival after liver resection for HCC can be expected in approximately 15% of patients. Recurrence does not preclude longterm survival. Recurrence at >2 years after resection, absence of vascular invasion, and absence of perioperative transfusion are independently associated with 10-year survival.