Influence of coexisting cirrhosis on long-term prognosis after surgery in patients with hepatocellular carcinoma.
Influence of coexisting cirrhosis on long-term prognosis after surgery in patients with hepatocellular carcinoma.
复制标题
合并肝硬化对肝细胞癌患者术后长期预后的影响。
DOI：
10.5555/uri:pii:003960609290254w
复制
发表时间：
1992
期刊：
影响因子：
3.8
通讯作者：
T. Iwanaga
中科院分区：
文献类型：
--
作者：
Y. Sasaki;S. Imaoka;S. Masutani;I. Ohashi;O. Ishikawa;H. Koyama;T. Iwanaga
背景
肝硬化作为肝细胞癌（HCC）和肝硬化患者预后不良的原因之一，其本身的影响尚未明确。
方法
我们比较了HCC和肝硬化患者的术后长期病程与HCC和无肝硬化患者的病程，以确定共存的肝硬化如何影响手术后的预后。接受根治性肝切除术的HCC患者包括142例组织学证实的肝硬化和48例无肝硬化。
结果
肝硬化患者的5年、7年和9年生存率分别为44%、32%和26%，无肝硬化患者的5年、7年和9年生存率分别为68%、57%和57%。肝硬化组预后明显差于无肝硬化组。两组死亡的主要原因是癌症复发。肝硬化患者3年及以后的无复发生存率明显低于无肝硬化患者。背景因素的比较显示，与非肝硬化患者相比，肝硬化患者在肿瘤相关因素和手术因素方面没有实质性的劣势。小切除和大切除后的无复发生存率表明肝硬化组比无肝硬化组局限性肝切除的缺点少。此外，与无肝硬化组相比，肝硬化组的无复发生存期在较低的晚期比在较晚期更短。
结论
肝硬化的高致癌性可能是肝癌合并肝硬化患者术后预后差的最可能原因。
BACKGROUND
As one of the reasons for the poor prognosis of patients with hepatocellular carcinoma (HCC) and cirrhosis, the influence of cirrhosis itself has not been clarified.
METHODS
We compared the postoperative long-term courses of patients with HCC and cirrhosis with the courses of patients with HCC and without cirrhosis to determine how the coexisting cirrhosis affected the prognosis after surgery. The patients with HCC who underwent curative hepatic resection consisted of 142 with associated histologically confirmed cirrhosis and 48 without cirrhosis.
RESULTS
The 5-, 7-, and 9-year survival rates were 44%, 32%, and 26%, respectively, in the patients with cirrhosis and 68%, 57%, and 57%, respectively, in the patients without cirrhosis. The prognosis of the group with cirrhosis was significantly worse than that of the group without cirrhosis. The main cause of death in both groups was cancer recurrence. The patients with cirrhosis had significantly lower recurrence-free survival rates at 3 years and later than had the patients without cirrhosis. A comparison of the background factors revealed no substantive disadvantages with regard to tumor-related and surgical factors in the patients with cirrhosis compared with the patients without cirrhosis. The recurrence-free survival rates after minor and major resection indicated fewer disadvantages of limited hepatectomy in the group with cirrhosis than in the group without cirrhosis. Moreover, the recurrence-free survival of the group with cirrhosis was shorter at less advanced stages than at more advanced stages when compared with that of the group without cirrhosis.
CONCLUSIONS
The higher carcinogenic potential in cirrhosis could be presumed to be the most likely reason for the poorer prognosis after surgery in the patients with HCC and cirrhosis.