Risk factors for early death after liver resection in patients with solitary hepatocellular carcinoma
Risk factors for early death after liver resection in patients with solitary hepatocellular carcinoma
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DOI：
10.1007/s00534-005-1009-9
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发表时间：
2005-01-01
期刊：
影响因子：
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通讯作者：
Naganuma, S
中科院分区：
文献类型：
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作者：
Kondo, K;Chijiiwa, K;Naganuma, S
背景/目的。虽然大多数接受肝切除术治疗孤立性肝细胞癌（HCC）的患者具有相对公平的结果，但有些患者预后不良。本研究的目的是评估孤立性肝癌患者肝切除术后早期死亡的危险因素。在1990年至2002年期间因孤立性HCC接受肝切除术并能够在肝切除术后随访2年以上的合格患者（n = 110）被分为两组，早期死亡组18例，术后生存2年以上者92例。通过单因素和多因素分析评估肝切除术后早期死亡的危险因素。单因素分析显示，肿瘤大体分型、肿瘤直径、肉眼门静脉侵犯、显微镜下生长方式、显微镜下血管侵犯（MVI）和手术切缘宽度是影响肝转移的显著因素（P < 0.05）。多因素分析显示MVI的存在是复发性早期死亡的独立且显著的危险因素。在孤立性HCC患者中，MVI的存在表明预后不良。这些患者在肝切除术后的早期需要辅助化疗。
Background/Purpose. Although most patients who receive hepatectomy for a solitary hepatocellular carcinoma (HCC) have a relatively fair result, some have a poor prognosis. The aim of this study was to evaluate the risk factors for early death after hepatectomy in patients with a solitary HCC.Methods. Eligible patients (n = 110) who had undergone hepatectomy for solitary HCC between 1990 and 2002 and were able to be followed up for more than 2 years after the hepatectomy were divided into two groups, those who died of cancer recurrence within 2 years (early-death group; n = 18) and those who survived for more than 2 years after the surgery (survival group; n = 92). Risk factors for early death after liver resection were evaluated by univariate and multivariate analyses.Results. The gross tumor classification, tumor diameter, macroscopic portal vein invasion, microscopic growth pattern, microscopic vascular invasion (MVI), and the width of the surgical margin were significant (P < 0.05) factors by univariate analysis. Multivariate analysis showed that the presence of MVI was an independent and significant risk factor for early death of recurrence.Conclusions. Among patients with solitary HCC, the presence of MVI indicates a poor prognosis. These patients need adjuvant chemotherapy in the early period after hepatectomy.