Prognostic factors analysis for the long-term survival in solitary large hepatocellular carcinoma patients after hepatectomy
10.3760/cma.j.issn.0529-5815.2016.07.004
- VernacularTitle:孤立性大肝癌患者肝切除术后长期预后因素分析
- Author:
Wenbin GAO
1
;
Shuai XIAO
;
Xiong LEI
;
Lianyue YANG
Author Information
1. 中南大学湘雅医院外科
- Keywords:
Liver neoplasms;
Prognosis;
Solitary large hepatocellular carcinoma;
Clinicopathologic characteristic;
Microvascular invasion
- From:
Chinese Journal of Surgery
2016;54(7):492-497
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the prognostic factors that have affected the long-term survival of solitary large hepatocellular carcinoma (SLHCC) patients after hepatectomy.Methods The clinical data of 215 SLHCC patients accepted hepatectomy in the Xiangya Hospital,Central South University from January 2004 to December 2012 were retrospectively analyzed.There were 182 males and 33 females aged from 24 to 69 years(median age was 46 years).Using a variety of statistical methods,including the Kaplan-Meier estimator and the Log-rank test,the impacts of an array of clinicopathologic factors,such as age,gender,liver cirrhosis,chronic viral hepatitis,the Child-Pugh grading,microvascular invasion,macrovascular invasion and TNM staging,on the overall survival and the disease-free survival of SLHCC patients after hepatectomy were analyzed.The prognostic factors were evaluated by univariate and multivariate analyses for the long-term survival of SLHCC patients after hepatectomy.Results The whole group of patients with SLHCC showed 1-,3-,and 5-year overall survival rates of 88.1％,60.2％,and 41.7％,respectively,and exhibited 1-,3-,and 5-year disease-free survival rates of 80.1％,49.4％,and 33.6％,respectively.The 1-,3-,and 5-year overall survival rates and disease-free survival rates of SLHCC patients with microvascular invasion were 82.0％,45.1％,29.0％ and 69.6％,36.1％,23.5％,respectively.In addition,the 1-,3-,and 5-year overall survival rates and disease-free survival rates of SLHCC patients with macrovascular invasion were 64.7％,34.3％,18.3％ and 54.2％,24.1％,0,respectively.In contrast,the 1-,3-,and 5-year overall survival rates and disease-free survival rates of SLHCC patients without vascular invasion were 95.0％,72.3％,51.8％ and 90.1％,60.9％,42.9％,respectively.The results of univariate analysis indicated that liver cirrhosis,microvascular invasion,macrovascular invasion,TNM staging were hazardous factors for the overall survival of SLHCC patients (x2 =4.953,8.835,15.237,19.789 respectively,all P ＜0.05) ; while microvascular invasion,macrovascular invasion,TNM staging were risk factors for the diseasefree survival of SLHCC patients (x2 =12.974,13.247,24.516 respectively,all P ＜ 0.05).Furthermore,the multivariate analysis suggested that microvascular invasion,macrovascular invasion,TNM staging were the independent prognostic factors that have affected the overall survival and disease-free survival of SLHCC patients(all P ＜ 0.05).Conclusion Microvascular invasion,macrovascular invasion and TNM staging were the independent prognostic factors for the long-term survival of patients with SLHCC after hepatectomy.
