The effect of alkaline phosphatase and intrahepatic metastases in large hepatocellular carcinoma.
The effect of alkaline phosphatase and intrahepatic metastases in large hepatocellular carcinoma.
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DOI：
10.1186/1477-7819-11-40
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发表时间：
2013-02-21
影响因子：
3.2
通讯作者：
Park CK
中科院分区：
文献类型：
--
作者：
Kim JM;Kwon CH;Joh JW;Park JB;Ko JS;Lee JH;Kim SJ;Park CK
肝切除术是肝细胞癌的标准治疗方法。然而，由于手术切除的技术复杂性和对术后肝脏失代偿的恐惧，大肝癌构成了一个艰巨的挑战。我们分析了大肝癌(≥为10 cm)患者手术后的预后和预后因素。我们对2006年1月至2010年6月间91例肝切除术患者的病历进行了回顾性调查。生存分析采用Kaplan-Meier方法，预后因素采用Cox回归分析。在91名接受评估的患者中，大多数肿瘤与乙肝病毒(乙肝病毒)有关。肿瘤大小中位数为12.3 cm(10~21 cm)，多伴有微血管侵犯。术后死亡率为2.2%。中位无瘤生存期和总生存期分别为6个月和41个月。1、2、3年无瘤生存率分别为33.5%、29.3%、18.8%。1、2、3年总生存率分别为73.9%、63.7%、54.8%。在存活的患者中，69例(77.5%)在平均23.4±15.9个月的随访期内发生了肝癌复发。多因素分析显示，预测肝细胞癌复发的有统计学意义的因素是碱性磷酸酶、≥80IU/mL(P=0.009)和肝内转移(P=0.013)。我们的研究表明，术前血清碱性磷酸酶水平(≥80IU/L)和肝内转移可用于监测和预测肝癌患者的复发。
Hepatectomy is the standard treatment for HCC. However, large HCC poses a difficult challenge because of the technical complexity of surgical resection and the fear of postoperative hepatic decompensation. We analyzed the outcome and prognostic factors in patients with large hepatocellular carcinoma (HCC ≥10 cm) after surgery. We retrospectively investigated the medical records of 91 patients who had undergone hepatectomy between January 2006 and June 2010. A survival analysis was performed utilizing the Kaplan-Meier method and prognostic factors were evaluated using Cox regression analysis. Of the 91 patients evaluated, most tumors were associated with hepatitis B virus (HBV). The median tumor size was 12.3 cm (range, 10 to 21 cm), with microvascular invasion present in most patients. The postoperative mortality rate was 2.2%. The median disease-free survival and overall survival were six months and 41 months. The one-year, two-year, and three-year disease-free survival rates were 33.5%, 29.3%, and 18.8%, respectively. The one-year, two-year, and three-year overall survival rates were 73.9%, 63.7%, and 54.8%, respectively. Of the 89 surviving patients, 69 patients (77.5%) developed HCC recurrence during the mean follow-up period of 23.4 ± 15.9 months. On multivariate analysis, the statistically significant factors that predicted HCC recurrence were ALP ≥ 80 IU/mL (P = 0.009) and intrahepatic metastases (P = 0.013). Our study suggests that preoperative ALP levels (≥ 80 IU/L) and intrahepatic metastases could be utilized to monitor and predict recurrence in HCC patients.
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影响因子：
1.9
作者：
Poon, Ronnie Tung-Ping;Fan, Sheung-Tat
通讯作者：
Fan, Sheung-Tat
影响因子：
9.6
作者：
Chen, XP;Qiu, FZ;Zhang, BX
通讯作者：
Zhang, BX
DOI：
10.1016/j.jamcollsurg.2005.10.005
发表时间：
2006-02-01
影响因子：
5.2
作者：
Shah, SA;Greig, PD;Vollmer, CM
通讯作者：
Vollmer, CM
影响因子：
9
作者：
Liu, CL;Fan, ST;Wong, J
通讯作者：
Wong, J
影响因子：
2.6
作者：
Nagano, Y;Tanaka, K;Shimada, H
通讯作者：
Shimada, H