Evaluation of the new AJCC staging system for resectable hepatocellular carcinoma.
Evaluation of the new AJCC staging system for resectable hepatocellular carcinoma.
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DOI：
10.1186/1477-7819-9-114
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发表时间：
2011-09-30
影响因子：
3.2
通讯作者：
Chen MF
中科院分区：
文献类型：
--
作者：
Cheng CH;Lee CF;Wu TH;Chan KM;Chou HS;Wu TJ;Yu MC;Chen TC;Lee WC;Chen MF
本研究的目的是评估第七版美国癌症联合委员会（AJCC） TNM系统（TNM-7）对肝切除术后肝细胞癌（HCC）患者的有效性。回顾性分析了1993年至2005年879例肝部分切除术患者。分析临床病理因素、手术结果、总生存期（OS）和无病生存期（DFS）来评估TNM-7分期系统的预测价值。根据TNM-7系统，I期、II期和III期的5年生存率差异具有统计学意义。III期患者亚组分析显示，II期与IIIA期无显著差异（OS, p = 0.246； DFS, p = 0.105）。对IIIA期、IIIB期和IIIC期进一步分层也没有发现显著差异。III期分析的Cox比例风险模型确定了影响患者生存的其他临床病理因素：缺乏肿瘤包封、天冬氨酸转氨酶（AST）值> 68 U/L和失血> 500 mL影响DFS，而缺乏肿瘤包封、AST值> 68 U/L、失血> 500 mL和血清α-胎蛋白（AFP）值> 200 ng/mL是影响OS的独立因素。III期因素包括肿瘤血栓、卫星病变和肿瘤破裂似乎不影响III期亚组的生存。在5年生存率方面，TNM-7系统能够将肝切除术后HCC患者分为I期、II期和III期，但无法将III期患者分为IIIA、IIIB和IIIC期。肿瘤包封缺失、AST值bbb68 U/L、出血量>500 mL、AFP值>200 ng/mL是影响长期生存的独立预后因素。
The aim of this study was to assess the validity of the 7th edition of the American Joint Committee on Cancer (AJCC) TNM system (TNM-7) for patients undergoing hepatectomy for hepatocellular carcinoma (HCC). Partial hepatectomies performed for 879 patients from 1993 to 2005 were retrospectively reviewed. Clinicopathological factors, surgical outcome, overall survival (OS), and disease-free survival (DFS) were analyzed to evaluate the predictive value of the TNM-7 staging system. According to the TNM-7 system, differences in five-year survival between stages I, II, and III were statistically significant. Subgroup analysis of stage III patients revealed that the difference between stages II and IIIA was not significant (OS, p = 0.246; DFS, p = 0.105). Further stratification of stages IIIA, IIIB and IIIC also did not reveal significant differences. Cox proportional hazard models of stage III analyses identified additional clinicopathological factors affecting patient survival: lack of tumor encapsulation, aspartate aminotransferase (AST) values > 68 U/L, and blood loss > 500 mL affected DFS whereas lack of tumor encapsulation, AST values > 68 U/L, blood loss > 500 mL, and serum α-fetoprotein (AFP) values > 200 ng/mL were independent factors impairing OS. Stage III factors including tumor thrombus, satellite lesions, and tumor rupture did not appear to influence survival in the stage III subgroup. In terms of 5-year survival rates, the TNM-7 system is capable of stratifying post-hepatectomy HCC patients into stages I, II, and III but is unable to stratify stage III patients into stages IIIA, IIIB and IIIC. Lack of tumor encapsulation, AST values > 68 U/L, blood loss > 500 mL, and AFP values > 200 ng/mL are independent prognostic factors affecting long-term survival.
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影响因子：
3.8
作者：
Hua, Zhan;Chen, Jingzhou;Yao, Li
通讯作者：
Yao, Li
DOI：
10.1111/j.1440-1746.2010.06329.x
发表时间：
2011-02-01
影响因子：
4.1
作者：
Chan, Stephen L.;Mo, Frankie K. F.;Yeo, Winnie
通讯作者：
Yeo, Winnie
影响因子：
6.2
作者：
Cho, Yun Ku;Chung, Jin Wook;Byun, Jong Hoon
通讯作者：
Byun, Jong Hoon
DOI：
10.1016/j.jamcollsurg.2006.06.030
发表时间：
2006-10-01
影响因子：
5.2
作者：
Lei, Hao-Jan;Chau, Gar-Yang;Wu, Chew-Wun
通讯作者：
Wu, Chew-Wun
影响因子：
254.7
作者：
Parkin, DM;Bray, F;Pisani, P
通讯作者：
Pisani, P