Significance of Platelet Count in the Outcomes of Hepatectomized Patients with Hepatocellular Carcinoma Exceeding the Milan Criteria
Significance of Platelet Count in the Outcomes of Hepatectomized Patients with Hepatocellular Carcinoma Exceeding the Milan Criteria
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DOI：
10.1007/s11605-011-1538-2
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发表时间：
2011-07-01
影响因子：
3.2
通讯作者：
Ohdan, Hideki
中科院分区：
文献类型：
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作者：
Amano, Hironobu;Tashiro, Hirotaka;Ohdan, Hideki
不符合米兰标准（MC）的晚期肝细胞癌（HCC）的适当治疗策略尚不清楚。本研究的目的是确定手术治疗的意义，为这样的patients.From 1990年1月至2007年12月，151例HCC超过MC谁接受根治性手术治疗的患者参加。生存和复发数据和临床病理因素进行了检查。对预后因素进行回顾性分析，以确定那些有助于改善手术结果的因素。在首次肝切除术后，本研究中的151例患者的3年、5年和10年总生存率分别为73%、55%和33%;相应的无病生存率分别为36%、30%和17%。单因素分析显示，血小板计数低于10（5）/mm 3、多发肿瘤和非癌组织肝硬化是不良生存和无病生存因素。多因素分析显示血小板计数是独立的预后因素。在血小板计数≥ 10（5）/mm（3）的患者中，超过MC的HCC的3年、5年和10年总生存率分别达到76%、65%和44%，与符合MC的患者相当（分别为86%、68%和37%）。对超过MC的晚期HCC患者进行肝切除术可提高生存率，特别是对于血小板计数足够高的患者，尽管初次肝切除术后的复发率很高。
The appropriate treatment strategy for advanced hepatocellular carcinoma (HCC) that does not meet the Milan criteria (MC) is unclear. The aim of this study was to determine the significance of surgical treatment for such patients.From January 1990 to December 2007, 151 patients with HCC exceeding MC who underwent curative surgical treatment were enrolled. Survival and recurrence data and clinicopathological factors were examined. Prognostic factors were analyzed to identify those that contributed to improved surgical outcomes retrospectively.After the initial hepatectomy, the overall 3-, 5-, and 10-year survival rates were 73%, 55%, and 33%, respectively, for the 151 patients in this study; the corresponding disease-free survival rates were 36%, 30%, and 17%, respectively. A platelet count under 10(5)/mm(3), multiple tumors, and liver cirrhosis of noncancerous tissue were adverse survival and disease-free survival factors by univariate analysis. Platelet count was an independent prognostic factor by multivariate analysis. The 3-, 5-, and 10-year overall survival rates of HCC exceeding MC in patients whose platelet count was 10(5)/mm(3) or greater reached 76%, 65%, and 44%, respectively, and were comparable with those that met MC (86%, 68%, and 37%, respectively).Hepatectomy for patients with advanced HCC exceeding MC improves survival, especially for patients with a sufficiently high platelet count, although recurrence rates after initial hepatectomy are high.