Analysis of short-and long-term prognostic factors for patients with spontaneous rupture and bleeding ;of primary liver cancer
10.3877/cma.j.issn.2095-3232.2016.02.008
- VernacularTitle:原发性肝癌自发破裂出血患者近期及远期预后因素分析
- Author:
Feng ZHONG
1
;
Xinsheng CHENG
;
Jinzhong WANG
;
Yongxue GUO
;
Kun HE
;
Shibo SUN
Author Information
1. 南方医科大学深圳医院肝胆外科 1
- Keywords:
Liver neoplasms;
Rupture;
Hepatectomy;
Prognosis;
Regression analysis
- From:
Chinese Journal of Hepatic Surgery（Electronic Edition）
2016;5(2):95-100
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the short- and long-term prognostic factors for patients with spontaneous rupture and bleeding of primary liver cancer (liver cancer). Methods Clinical data of 167 patients with spontaneous rupture and bleeding of liver cancer admitted to Jiangmen Hospital, Southern Medical University and Nanshan Hospital, Guangdong Medical College between January 2005 and December 2012 were retrospectively analyzed. There were 140 males and 27 females with the average age of (58±7) years. The informed consents of all patients were obtained and the local ethical committee approval was received. Seventy-eight cases were diagnosed with Child-Pugh classiifcation A, 44 with Child-Pugh classiifcation B and 45 with Child-Pugh classiifcation C. According to the tumor, node, metastasis (TNM) stage, 31 cases were in stageⅡ, 54 in stageⅢ, 73 in stageⅣA and 9 in stageⅣB. The 30-d and long-term survival rates were analyzed. The inlfuencing factors of survival rates were analyzed by Cox's proportional hazard regression model. Results The 30-d survival rate was 71.3%, and the 1-, 3-, 5-year accumulative survival rate was 40.1%, 16.5%, 5.4% respectively. Multiviariate Cox's regression analysis revealed that Child-Pugh classiifcation C, hypovolemic shock, number of tumors≥2, TNM stage Ⅲ and conservative therapy were the independent risk factors for 30-d survival rate (HR=9.503, 2.919, 4.760, 0.283, 32.004; P<0.05). Liver cirrhosis, Child-Pugh classification C, total bilirubin (TB)≥34 μmol/L, number of tumors≥2, TNM stageⅢand conservative therapy were the independent risk factors for long-term survival rate (HR=9.167, 5.950, 1.037, 2.821, 0.680, 8.147; P<0.05). Conclusions For patients with spontaneous rupture and bleeding of liver cancer, Child-Pugh classiifcation C, hypovolemic shock, number of tumors≥2, TNM stageⅢand conservative therapy are the independent risk factors for short-term pronosis, whereas liver cirrhosis, Child-Pugh classiifcation C, TB≥34μmol/L, number of tumors≥2, TNM stageⅢand conservative therapy are the independent risk factors for long-term pronosis.
