Clinical characteristics and prognostic factors for advanced hepatocellular carcinoma with extrahepatic metastasis
Clinical characteristics and prognostic factors for advanced hepatocellular carcinoma with extrahepatic metastasis
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DOI：
10.3892/mco.2014.259
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发表时间：
2014-05-01
影响因子：
1.2
通讯作者：
Sata, Michio
中科院分区：
文献类型：
--
作者：
Aino, Hajime;Sumie, Shuji;Sata, Michio
肝细胞癌是世界范围内最常见的恶性肿瘤之一。本研究的目的是评估接受治疗和未接受治疗的晚期肝癌肝外转移患者的临床特征和生存率是否存在差异。自1998年4月至2012年4月，共有419例有肝外转移的肝细胞癌患者(81例未经治疗，338例接受治疗)纳入本研究。比较两组在临床特征，包括转移部位方面的差异。此外，对所有患者和81例既往未治疗患者的预后预测因素进行了分析。两组的主要转移部位分布相似，最常见的肝外转移部位是肺，其次是骨、淋巴结和肾上腺。中位生存期(MST)为6.8个月。1、2、3、5年生存率分别为31.6%、15.3%、9.5%和2.3%。接受治疗的患者和未接受治疗的患者之间的存活率没有显著差异。多因素分析显示Child-Pugh分级、白细胞计数、中性粒细胞/淋巴细胞比率(NLR)和原发肿瘤分期是影响所有患者和81例初治患者生存的独立因素。接受过治疗和没有接受过治疗的晚期肝癌合并肝外转移患者的临床特征有所不同。此外，肝内肿瘤状态、Child-Pugh分级、白细胞计数和NLR是肝癌合并肝外转移患者生存的独立预测因素。
Hepatocellular carcinoma (HCC) is one of the most common malignancies worldwide. The aim of this study was to evaluate whether there are differences in the clinical characteristics and survival between patients with advanced HCC with extrahepatic metastasis who received and those who did not receive previous treatment. Between April, 1998 and April, 2012, a total of 419 HCC patients with extrahepatic metastasis (81 previously untreated and 338 previously treated) were enrolled in this study. The differences in the clinical characteristics, including metastatic sites, were compared between the two groups. In addition, the prognostic predictors among all the patients and among the 81 previously untreated patients were analyzed. The distribution of the major metastatic sites was similar in the two groups; the most frequent site of extrahepatic metastasis was the lungs, followed by the bones, lymph nodes and adrenal glands. The median survival time (MST) among the 419 patients was 6.8 months. The 1-, 2-, 3- and 5-year survival rates were 31.6, 15.3, 9.5 and 2.3%, respectively. No significant differences in survival were observed between patients who received and those who did not receive previous treatment. The multivariate analysis revealed that the Child-Pugh classification, white blood cell count, neutrophil-lymphocyte ratio (NLR) and primary tumor stage were independent predictors of survival for all the patients and for the 81 previously untreated patients. Differences in the clinical characteristics of patients with advanced HCC with extrahepatic metastasis were identified between patients who received and those who did not receive previous treatment. Furthermore, intrahepatic tumor status, Child-Pugh classification, white blood cell count and NLR were demonstrated to be independent predictors of survival in HCC patients with extrahepatic metastasis.