Impact of postoperative complications on long-term outcome of curative resection for hepatocellular carcinoma
Impact of postoperative complications on long-term outcome of curative resection for hepatocellular carcinoma
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DOI：
10.1002/bjs.6358
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发表时间：
2009-01-01
影响因子：
9.6
通讯作者：
Fan, S. T.
中科院分区：
文献类型：
--
作者：
Chok, K. S.;Ng, K. K.;Fan, S. T.
背景资料：本回顾性研究的目的是确定术后并发症的影响油的长期结果的根治性肝切除术肝细胞癌（HCC）。方法：共863例肝癌根治性切除术从1989年12月至2004年12月被纳入分析。中位随访时间为35.6个月。结果：约288例患者（33.4%）出现术后并发症。住院死亡率为5.3%（46名患者）。多因素Logistic回归分析显示，高龄和术中大量失血与并发症发生率显著升高相关。有和无术后并发症的患者的人口统计学资料相当。前者的失血量明显更多（中位数为1.1升对0.7升; P < 0.001），需要更多的输血（P < 0.001）。无并发症患者的1年、3年、5年和10年总生存率分别为83.6%、62.8%、51.5%和32.1%。并发症发生率分别为67.8%、52.4%、41.5%和26.6%（P = 0.004）。考克斯比例风险模型分析显示，术后并发症的存在与总生存率低独立相关。结论：术后并发症可影响肝癌切除术后的总长期生存率。
Background: The aim of this retrospective study was to determine the impact of postoperative complications oil the long-term outcome of curative liver resection for hepatocellular carcinoma (HCC).Methods: A total of 863 patients who had curative resection of HCC from December 1989 to December 2004 were included in the analysis. Median follow-up was 35.6 months.Results: Some 288 patients (33.4 per cent) developed postoperative complications. The hospital mortality rate was 5.3 per cent (46 patients). Multiple logistic regression analysis showed that older age and massive intraoperative blood loss were related to a significantly higher complication rate. Demographics of patients with and without postoperative complications were comparable. The former had significantly more blood loss (median 1.1 versus 0.7 litres; P < 0.001) and required more transfused blood (P < 0.001). The overall survival rates of patients without complications at 1, 3, 5 and 10 years were 83.6, 62.8, 51.5 and 32.1 per cent respectively. Corresponding rates for those with complications were 67.8, 52.4, 41.5 and 26.6 per cent (P = 0.004). Cox proportional hazard model analysis revealed that the presence of postoperative complications was independently associated with poor overall survival.Conclusion: postoperative complications can affect overall long-term survival after resection of HCC.