Tumor doubling tune predicts recurrence after surgery and describes the histological pattern of hepatocellular carcinoma on cirrhosis
Tumor doubling tune predicts recurrence after surgery and describes the histological pattern of hepatocellular carcinoma on cirrhosis
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DOI：
10.1016/j.jhep.2005.03.014
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发表时间：
2005-08-01
影响因子：
25.7
通讯作者：
Pinna, AD
中科院分区：
文献类型：
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作者：
Cucchetti, A;Vivarelli, M;Pinna, AD
背景/目标：手术切除后肝细胞癌（HCC）的复发受切除标本或活检可检测参数的影响。肝癌倍增时间（DT）术后的预后意义从来没有investigated.Methods：我们评估了62例患者谁接受了根治性切除术的一个单一的肝细胞癌肝硬化，肿瘤进行了评估，手术前的两个随后的场合与相同的成像技术，允许DT的计算。单因素和多因素分析肿瘤DT、临床和病理参数对复发率和患者生存的影响。结果：3年复发率为32.3%（20例患者）：在DT短于100天的情况下，这显著更高（58%对18%，当等于或更长时; P=0.008），微血管浸润（59对17%，当不存在时; P=0.008）或肿瘤未分化（54对25%，当良好/中度分化时; P=0.015）。DT是复发的唯一独立预测因子（P=0.005）。患者生存率仅受Child-Pugh分级影响。有微血管浸润（P=0.007）、未分化（P=0.003）和甲胎蛋白水平高（P=0.011）的肝癌DT明显短于无微血管浸润的肝癌（P =0.007）。2005年欧洲肝脏研究协会。Elsevier B. V.出版，保留所有权利。
Background/Aims: Recurrence of hepatocellular carcinoma (HCC) following surgical resection is influenced by parameters detectable on the resection specimen or through a biopsy. The prognostic significance of HCC doubling time (DT) after surgery has never been investigated.Methods: We evaluated 62 patients who underwent curative resection of a single HCC on cirrhosis; tumors were assessed before surgery on two subsequent occasions with the same imaging technique allowing the calculation of DT. The influence of tumor DT, clinical and pathological parameters on recurrence-rate and patients survival was assessed with uni- and multivariate analysis. Relationship between DT and pathological features was also analyzed.Results: Three-year recurrence rate was 32.3% (20 patients): this was significantly higher in the presence of DT shorter than 100 days (58 versus 18% when equal to or longer; P=0.008), microvascular invasion (59 versus 17% when absent; P=0.008) or tumor undifferentiation (54 versus 25% when well/moderately differentiated; P=0.015). DT was the only independent predictor of recurrence (P=0.005). Patients survival was affected by Child-Pugh class only. DT was significantly shorter in tumors with microvascular invasion (P=0.007), undifferentiation (P=0.003) and high alpha-fetoprotein levels (P=0.011).Conclusions: DT is easy to estimate and indicates the prognosis of single HCCs prior to liver resection. 2005 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.