Long- versus short-interval follow-up after resection of hepatocellular carcinoma: a retrospective cohort study.
Long- versus short-interval follow-up after resection of hepatocellular carcinoma: a retrospective cohort study.
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肝细胞癌切除后的长间隔与短间隔随访：一项回顾性队列研究
DOI：
10.1186/s40880-018-0296-x
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发表时间：
2018-05-21
期刊：
影响因子：
--
通讯作者：
Yuan Y
中科院分区：
文献类型：
--
作者：
He W;Zheng Y;Zou R;Shen J;Yang J;Qiu J;Tao Q;Liu W;Yang Z;Zhang Y;Li B;Yuan Y
背景：由于关于最佳随访时间间隔的证据有限，肝细胞癌（HCC）切除术患者的平均术后随访时间间隔各不相同。我们的目的是比较在危险分层的HCC患者中，长时间随访和短时间随访与生存和复发的关系。方法2007 - 2014年进行回顾性队列研究。根据最小绝对收缩和选择手术算法确定的预后因素，共对1227例接受根治性切除的巴塞罗那临床肝癌A期或B期HCC患者进行早期复发（切除后2年内）低（n = 865）或高（n = 362）风险分层。根据术后2年内随访情况，将患者进一步分为长间隔（每4-6个月一次）和短间隔（每2 - 4个月一次）随访亚组（低风险，长间隔vs短间隔：n = 390 vs. n = 475；高风险，长间隔vs.短间隔：n = 149 vs. n = 213）。结果短间隔随访并没有延长低危患者（风险比[HR] = 1.152； 95%可信区间[CI] 0.720-1.843）或高危患者（HR = 1.213； 95%可信区间[CI] 0.702-2.094）的总生存期。401例患者出现早期复发。对于高危患者，短时间间隔随访组比长时间间隔随访组表现出更小的肝内复发率（分别为2.6和3.5 cm, P = 0.045）。然而，无论是低风险患者还是高风险患者，巴塞罗那临床肝癌0/A期复发率在长间隔随访组和短间隔随访组之间均无显著差异（分别为63.1%对68.2%,P = 0.580；分别为31.3%对41.5%,P = 0.280）。低危和高危患者的复发率（分别为34.5%对39.7%,P = 0.430； 14.6%对20.3%,P = 0.388）在随访组之间也相似。结论将术后随访时间从4-6个月缩短至2 - 4个月，并不能提高巴塞罗那临床肝癌A期或B期HCC患者的治愈意图治疗率或延长总生存期。
BackgroundAverage postoperative follow‐up intervals vary in patients undergoing hepatocellular carcinoma (HCC) resection because of limited evidence regarding the optimal interval. We aimed to compare the associations of long‐versus short‐interval follow‐up with survival and recurrence in risk‐stratified HCC patients.MethodsWe performed a retrospective cohort study between 2007 and 2014. In total, 1227 patients treated by curative resection of Barcelona Clinic Liver Cancer stage A or B HCC were stratified as having a low (n = 865) or high (n = 362) risk of early recurrence (within the first 2 years after resection) based on prognostic factors identified by the least absolute shrinkage and selection operation algorithm. Patients were further classified into long‐interval (every 4–6 months) and short‐interval (every 2–4 months) follow‐up subgroups based on follow‐up within 2 years after resection (low risk, long vs. short: n = 390 vs. n = 475; high‐risk, long vs. short: n = 149 vs. n = 213).ResultsThe short‐interval follow‐up did not prolong overall survival in either the low‐risk (hazard ratio [HR] = 1.152; 95% confidence interval [CI] 0.720–1.843) or high‐risk (HR = 1.213; 95% CI 0.702–2.094) patients. Early recurrence occurred in 401 patients. For high‐risk patients, the short‐interval follow‐up subgroup exhibited smaller intrahepatic recurrence than did the long‐interval group (2.6 vs. 3.5 cm, respectively, P = 0.045). However, no significant difference in the rate of Barcelona Clinic Liver Cancer stage 0/A recurrence was found between the long‐ and short‐interval follow‐up groups in either low‐ or high‐risk patients (63.1% vs. 68.2%, respectively, P = 0.580; 31.3% vs. 41.5%, respectively, P = 0.280). The rate of curative intent treatment for recurrence (34.5% vs. 39.7%, respectively, P = 0.430; 14.6% vs. 20.3%, respectively, P = 0.388) was also similar between the follow‐up groups for low‐ and high‐risk patients.ConclusionsShortening the postoperative follow‐up interval from every 4–6 months to every 2–4 months within the first 2 years after resection did not increase the rate of curative intent treatment or prolong the overall survival of patients with Barcelona Clinic Liver Cancer stage A or B HCC.
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影响因子：
158.5
作者：
Llovet, Josep M.;Ricci, Sergio;Bruix, Jordi
通讯作者：
Bruix, Jordi
影响因子：
45.3
作者：
Kopetz, Scott;Chang, George J.;McWilliams, Robert R.
通讯作者：
McWilliams, Robert R.
影响因子：
3.4
作者：
Soini, Y;Virkajarvi, N;Paakko, P
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Paakko, P
影响因子：
254.7
作者：
Parkin, DM;Bray, F;Pisani, P
通讯作者：
Pisani, P
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影响因子：
51.1
作者：
Cheng, Ann-Lii;Kang, Yoon-Koo;Guan, Zhongzhen
通讯作者：
Guan, Zhongzhen