Tumor-related factors do not influence the prognosis of solitary hepatocellular carcinoma after partial hepatectomy
Tumor-related factors do not influence the prognosis of solitary hepatocellular carcinoma after partial hepatectomy
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DOI：
10.1007/s00534-011-0379-4
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发表时间：
2011-03
影响因子：
3
通讯作者：
Tsuyoshi Kobayashi;T. Itamoto;H. Tashiro;H. Amano;A. Oshita;Yoshisato Tanimoto;S. Kuroda;H. Tazawa;H. Ohdan
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文献类型：
--
作者：
Tsuyoshi Kobayashi;T. Itamoto;H. Tashiro;H. Amano;A. Oshita;Yoshisato Tanimoto;S. Kuroda;H. Tazawa;H. Ohdan
背景/目的尽管许多与肿瘤或肝储备功能相关的因素可能影响肝细胞癌（HCC）部分肝切除术的结果，但这些因素在孤立性HCC患者中尚未得到深入研究。本研究的目的是确定影响孤立性HCC行部分肝切除术的长期预后的临床病理因素。MethodsData对1997年至2006年间连续266例接受根治性肝切除术的孤立性HCC患者的预后进行了分析。分别总生存率的显著独立预测因素包括丙型肝炎病毒感染、肝硬化和凝血酶原活动度延长。3年、5年和10年的无病生存率分别为51.7%、41.1%和20.4%。无病生存期的显著独立预测因素包括天冬氨酸氨基转移酶水平升高、血小板计数降低、肝硬化和凝血酶原活性延长。肿瘤相关因素，如肿瘤大小和显微血管浸润的总体或无病surviv.ConclusionsThe长期结果的孤立性肝癌患者进行部分肝切除术主要取决于背景肝脏状态，但不是肿瘤相关因素，这表明，部分肝切除术是一种非常有效的抗肿瘤治疗。如果肝储备功能在允许的范围内，肝部分切除术应被视为孤立性HCC患者的治疗选择。
Background/purposeAlthough many factors related to the tumor or the hepatic functional reserve may affect the outcome of partial hepatectomy for hepatocellular carcinoma (HCC), these factors have not yet been intensively investigated in patients with solitary HCC. The purpose of this study is to determine the clinicopathological factors influencing the long‐term outcomes of partial hepatectomy for solitary HCC.MethodsData on 266 consecutive patients with a solitary HCC who underwent curative hepatectomy between 1997 and 2006 were analyzed with regard to prognosis.ResultsOverall survival rates at 3, 5, and 10 years were 89.5, 79.6, and 56.1%, respectively. The significant independent predictors for overall survival included hepatitis C virus infection, liver cirrhosis, and prolonged prothrombin activity. Disease‐free survival rates at 3, 5, and 10 years were 51.7, 41.1, and 20.4%, respectively. The significant independent predictors for disease‐free survival included elevated levels of aspartate amino transferase, decreased platelet counts, presence of liver cirrhosis, and prolonged prothrombin activity. Tumor‐related factors such as tumor size and microscopic vascular invasion were not significant predictors of overall or disease‐free survival.ConclusionsThe long‐term outcomes of patients with a solitary HCC who underwent partial hepatectomy mainly depended on the background liver status but not on tumor‐related factors; this suggests that partial hepatectomy is a remarkably effective antitumor therapy. If the hepatic functional reserve is within the permissible range, partial hepatectomy should be considered as the treatment of choice for patients with a solitary HCC.