Clinicopathologic features of long-term survivors and disease-free survivors after resection of hepatocellular carcinoma: A study of a prospective cohort
Clinicopathologic features of long-term survivors and disease-free survivors after resection of hepatocellular carcinoma: A study of a prospective cohort
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DOI：
10.1200/jco.2001.19.12.3037
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发表时间：
2001-06-15
影响因子：
45.3
通讯作者：
Wong, J
中科院分区：
文献类型：
--
作者：
Poon, RTP;Ng, IOL;Wong, J
目的：本研究旨在阐明肝细胞癌切除术后长期生存者和无病生存者的临床病理特征。患者和方法：对230例前瞻性观察> 5年的患者进行队列研究，阐明5年生存者和无病生存者的临床病理特征结果：5年生存率为37%（85/230），5年无瘤生存率为20%（45/230）。与5年存活者相关的临床病理学特征包括女性（P = .024），术前血清白蛋白≥ 40 g/L（P = .033），AST < 50 u/L（P = .001），肿瘤< 5 cm（P = .001），孤立性肿瘤（P = 0.035），包裹性肿瘤（P = 0.021），无静脉侵犯（P = 0.001）、无微卫星结节（P = 0.001）和早期病理肿瘤-淋巴结转移（pTNM）分期（I或II，P <0.001）。有利于5年无病生存的特征是术前血清AST < 50 u/L（P = .007），肿瘤< 5 cm（P = .005），有包膜的肿瘤（P = .007），无静脉倒置（P < .001），无微卫星结节（P =.001），pTNM分期早期（I或II，P < .001）。通过多变量分析，pTNM分期是总生存期和无病生存期的唯一重要预测因素。结论：本研究表明，具有良好肿瘤特征的患者可以实现肝癌切除后> 5年的长期无病生存。早期pTNM分期是长期总体生存率和无病生存率的最可靠预测因素。J Clin Oncol 79：3037-3044. (C)2001年，美国临床肿瘤学会。
Purpose: This study aims to clarify the clinicopathologic features of long-term survivors and disease-free survivors after resection of hepatocellular carcinoma (HCC).Patients and Methods: The clinicopathologic features of 5-year survivors and disease-free survivors were elucidated in a cohort of 230 patients prospectively observed for > 5 years (64 to 192 months) after curative resection of HCC.Results: The incidence of 5-year overall and disease-free survivors were 37% (85 of 230) and 20% (45 of 230), respectively. Clinicopathologic features associated with 5-year survivors included female sex (P = .024), preoperative serum albumin greater than or equal to 40 g/L (P = .033), AST < 50 u/L (P = .001), tumor < 5 cm (P = .001), solitary tumor (P = .035), encapsulated tumor (P = .021), no venous invasion (P = .001), no microsatellite nodule (P =.001), and early pathologic tumor-nodemetastasis (pTNM) stage (I or II, P < .001). Features favoring 5-year disease-free survivors were preoperative serum AST < 50 u/L (P = .007), tumor < 5 cm (P = .005), encapsulated tumor (P = .007), no venous inversion (P < .001), no microsatellite nodule (P =.001), and early pTNM stage (I or II, P < .001). By multivariate analysis, pTNM stage was the only significant predictive factor for both overall and disease-free survival.Conclusion: This study shows that long-term disease-free survival > 5 years after resection of HCC can be achieved in patients with favorable tumor characteristics. Early pTNM stage was the most reliable predictor of both long-term overall and disease-free survivors. J Clin Oncol 79:3037-3044. (C) 2001 by American Society of Clinical Oncology.