Multiple Tumors Located in the Same Section Are Associated with Better Outcomes After Hepatic Resection for HCC Patients Meeting the Milan Criteria
Multiple Tumors Located in the Same Section Are Associated with Better Outcomes After Hepatic Resection for HCC Patients Meeting the Milan Criteria
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对于符合米兰标准的 HCC 患者，位于同一部位的多个肿瘤与肝切除术后更好的结果相关
DOI：
10.1007/s11605-015-2959-0
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发表时间：
2015-12-01
影响因子：
3.2
通讯作者：
Xu, Mingqing
中科院分区：
文献类型：
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作者：
Lv, Tao;Jiang, Li;Xu, Mingqing
肿瘤位置对多灶性肝细胞癌（HCC）肝切除术（HR）后结局的影响仍知之甚少。本研究的目的是比较符合米兰标准的多灶性肿瘤和肿瘤位于相同或不同切片的HR患者的短期和长期结局。共219例符合米兰标准的多灶性肿瘤的连续HR患者根据其解剖位置（Couinaud分割）分为SS组（n = 97;相同切片）和DS组（n = 122;不同切片）。评估预后预测因素，并进行亚组分析。SS组的1、3、5年总生存率（OS）和无复发生存率（RFS）明显高于DS组。亚组分析显示，在同一节段中有两个肿瘤的患者和接受整块切除术的患者具有更好的OS和RFS。多因素分析显示肿瘤位于不同部位和大血管侵犯是预后不良的独立预测因素。在符合米兰标准的多灶性肿瘤的HCC患者中，位于同一肝脏切片的肿瘤可能比HR后不同切片的肿瘤具有更好的长期生存率和更低的HCC复发率。
The impact of the tumor location on the outcome after hepatic resection (HR) in multifocal hepatocellular carcinoma (HCC) is still poorly understood. The aim of this study was to compare the short- and long-term outcomes of HR patients with multifocal tumors meeting the Milan criteria and tumors located in the same or different sections. A total of 219 consecutive HR patients with multifocal tumors meeting the Milan criteria were divided into group SS (n = 97; same section) and group DS (n = 122; different sections) according to their anatomical location (Couinaud's segmentation). The prognostic predictors were evaluated, and a subgroup analysis was performed. The 1-, 3-, and 5-year overall survival (OS) and recurrence-free survival (RFS) rates were significantly higher in group SS than group DS. The subgroup analysis showed that patients with two tumors in the same section and patients undergoing en bloc resection had better OS and RFS. A multivariate analysis revealed that tumors located in different sections and macrovascular invasion were independent predictors of poor prognosis. In HCC patients with multifocal tumors meeting the Milan criteria, tumors located in the same hepatic section may lead to better long-term survival and lower HCC recurrence rates than tumors in different sections after HR.