Analysis of the factors affecting the efficacy,safety and prognosis of R0 resection in hepatocellular carcinoma patients with portal hypertension
10.3969/j.issn.1005-6483.2017.03.006
- VernacularTitle:影响肝癌合并门脉高压症患者行R0切除的疗效、安全性及预后的因素分析
- Author:
Jin CHEN
;
Xiaolong WANG
;
Rixiang ZHU
- Keywords:
hepatocellular carcinoma;
portal hypertension;
hepatectomy;
prognosis
- From:
Journal of Clinical Surgery
2017;25(3):182-185
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the factors affecting the efficacy,safety and prognosis of R0 resection in hepatocellular carcinoma(HCC)patients with portal hypertension(PH).Methods Clinical data of 600 patients with cirrhosis related HCC undergoing hepatectomy at the Dept.of Hepatobiliary Surgery were studied retrospectively.According to whether the patients with portal hypertension or not,they were divided into PH group and non PH group.Postoperative complications and mortality were compared between the two groups.Kaplan-Meier was used to analyze influencing factors of patients with R0 postoperative survival.Cox regression risk model was used to analyze the risk factors.Results The operative mortality of PH group and non PH group was 3.6%(3/84)and 0.5%(1/216),respectively.The difference was statistically significant(P<0.05).The incidence of postoperative complications in PH group was 22.6%,significantly higher than 9.7% in non PH group(P<0.05),especially the incidence rate of the liver related complications(ascites>800 ml/d,hepatic insufficiency and liver failure).Alcoholism,with PH,AFP ≥20 ng/ml,tumor size>5cm and non-solitary type HCC(all P<0.05) were important factors for overall survival.Cox regression analysis showed that tumor size>5cm and non-solitary type HCC were independent predictors for survival.Conclusion PH combined with HCC patients after R0 resection can significantly increase the incidence of complications related to liver disease and mortality,tumor size >5cm and non-isolated HCC are the risk factors for long-term survival of patients.
