The role of clinically significant portal hypertension in hepatic resection for hepatocellular carcinoma patients: a propensity score matching analysis.
The role of clinically significant portal hypertension in hepatic resection for hepatocellular carcinoma patients: a propensity score matching analysis.
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具有临床意义的门脉高压在肝细胞癌患者肝切除术中的作用：倾向评分匹配分析
DOI：
10.1186/s12885-015-1280-3
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发表时间：
2015-04-11
期刊：
影响因子：
3.8
通讯作者：
Yuan Y
中科院分区：
文献类型：
--
作者：
He W;Zeng Q;Zheng Y;Chen M;Shen J;Qiu J;Chen M;Zou R;Liao Y;Li Q;Wu X;Li B;Yuan Y
背景门静脉高压症（PHT）是否是肝细胞癌（HCC）患者肝切除术（HR）的适当禁忌证仍存在争议。我们的目的是评估临床上显著的PHT对接受HR的HCC患者术后并发症和预后的影响。方法209例接受HR作为初始治疗的HCC患者根据是否存在PHT分为两组（n = 10）。102）或无临床显著PHT（n = 107）。结果PSM前PHT患者术后并发症发生率明显高于PSM前PHT患者（43.1% vs. 23.4%;P= 0.002）和肝脏失代偿（37. 3% vs. 17. 8%;P= 0. 002），无复发生存率（RFS;P= 0. 369）和总生存率（OS;P= 0. 205）与非PHT患者相似。然而，PSM后重复分析显示术后并发症（32.2% vs. 39.0%;P= 0.442）、肝功能失代偿（25.4% vs. 32.2%;P= 0.416）、RFS（P= 0.481）和OS（P= 0.417;每组59例患者）的发生率相似。PHT的存在与并发症的Logistic回归分析，或与总生存率的考克斯回归analysis.ConclusionsThe临床上显着PHT的存在对术后并发症和预后没有影响，不应被视为一个禁忌症的HR肝癌患者。
BackgroundWhether portal hypertension (PHT) is an appropriate contraindication for hepatic resection (HR) in hepatocellular carcinoma (HCC) patient is still under debate.Aims: Our aim was to assess the impact of clinically significant PHT on postoperative complication and prognosis in HCC patients who undergo HR.MethodsTwo hundred and nine HCC patients who underwent HR as the initial treatment were divided into two groups according to the presence (n = 102) or absence (n = 107) of clinically significant PHT. Propensity score matching (PSM) analysis was used to compare postoperative outcomes and survival.ResultsBefore PSM, PHT patients had higher rates of postoperative complication (43.1%vs. 23.4%;P= 0.002) and liver decompensation (37.3%vs. 17.8%;P= 0.002) with similar rates of recurrence-free survival (RFS;P= 0.369) and overall survival (OS;P= 0.205) compared with that of non-PHT patients. However, repeat analysis following PSM revealed similar rates of postoperative complication (32.2%vs. 39.0%;P= 0.442), liver decompensation (25.4%vs. 32.2%;P= 0.416), RFS (P= 0.481) and OS (P= 0.417; 59 patients in each group). Presence of PHT was not associated with complication by logistic regression analysis, or with overall survival by Cox regression analysis.ConclusionsThe presence of clinically significant PHT had no impact on postoperative complication and prognosis, and should not be regarded as a contraindication for HR in HCC patients.
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