Surgical resection for advanced hepatocellular carcinoma according to Barcelona Clinic Liver Cancer (BCLC) staging
Surgical resection for advanced hepatocellular carcinoma according to Barcelona Clinic Liver Cancer (BCLC) staging
复制标题
根据巴塞罗那临床肝癌 (BCLC) 分期对晚期肝细胞癌进行手术切除
DOI：
10.1007/s00432-012-1188-0
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发表时间：
2012-07-01
影响因子：
3.6
通讯作者：
Wu, Meng-Chao
中科院分区：
文献类型：
--
作者：
Yang, Tian;Lin, Chuan;Wu, Meng-Chao
目的BCLC分期已被广泛认可，以预测肝癌患者的预后。然而，它作为治疗指导手段的有效性需要受到质疑。本研究的目的是评估手术切除术的围手术期和长期的结果与晚期肝细胞癌（HCC）患者根据巴塞罗那临床肝癌（BCLC）staging.MethodsThis研究采用了前瞻性维护的数据库组成的一个连续系列的511名中国患者进行手术切除的肝胆外科中心，从2001年至2007年。死亡率，发病率，长期总生存期（OS）和无病生存期（DFS）进行了evaluated.ResultsHospital死亡率为2.3%，总发病率为31.3%。中位随访期为27.8个月（范围：0-112个月）后，1、3和5年OS率分别为69.9%、41.2%和30.5%，1、3和5年DFS率分别为48.2%、30.3%和24.0%。有血管侵犯和/或肝外扩散的患者的1年、3年和5年OS和DFS率明显低于无血管侵犯和/或肝外扩散的患者。有胆道侵犯的患者比无胆道侵犯的患者更差（P < 0.001）结论部分晚期肝癌患者可考虑手术切除（BCLC C期），具有低死亡率、可接受的发病率和有利的生存获益。这些结果意味着BCLC对晚期HCC治疗方案的建议需要重新评估。
PurposeThe BCLC staging classification has been widely endorsed to predict the prognosis of patients with HCC. However, its validity as a means of therapeutic instructions needs to be challenged. This study aimed to evaluate perioperative and long-term outcomes of surgical resection in patients with advanced hepatocellular carcinoma (HCC) according to the Barcelona Clinic Liver Cancer (BCLC) staging.MethodsThis study used a prospectively maintained database consisting of a consecutive series of 511 Chinese patients with advanced HCC who underwent surgical resection in a hepatobiliary surgical center from 2001 to 2007. Mortality, morbidity, long-term overall survival (OS) and disease-free survival (DFS) were evaluated.ResultsHospital mortality was 2.3%, and overall morbidity was 31.3%. After a median follow-up period of 27.8 months (range, 0–112 months), the 1-, 3- and 5-year OS rate was 69.9, 41.2 and 30.5%, and the 1-, 3- and 5-year DFS rate was 48.2, 30.3 and 24.0%, respectively. The 1-, 3- and 5-year OS and DFS rates were significantly poorer in patients with vascular invasion and/or extrahepatic spread than those in patients without (bothP< 0.001), and also poorer in patients with biliary invasion than those in patients without (bothP< 0.05).ConclusionsSurgical resection could be considered in part of patients with advanced HCC (BCLC stage C), with low mortality, acceptable morbidity and favorable survival benefits. These results imply that BCLC recommendations for treatment schedules of advanced HCC need to be re-evaluated.