Impact of regional lymph node metastasis on prognosis of patients with hepatocellular carcinoma after hepatectomy
10.3760/cma.j.issn.1007-8118.2017.12.003
- VernacularTitle:区域淋巴结转移对原发性肝细胞癌肝切除患者预后的影响
- Author:
Jie KONG
1
;
Haiwang ZHAO
;
Hui LI
;
Chen WANG
;
Quanbin XU
;
Zhiyong SUN
;
Yongqiang YE
Author Information
1. 274000,山东省菏泽市立医院肝胆外科
- Keywords:
Hepatocellular carcinoma;
Regional lymph node metastasis;
Recurrence;
Hepatectomy;
Prognosis
- From:
Chinese Journal of Hepatobiliary Surgery
2017;23(12):809-813
- CountryChina
- Language:Chinese
-
Abstract:
Objective To study the impact of regional lymph node metastasis on the prognosis of patients with hepatocellular carcinoma (HCC) after hepatectomy.Methods Three hundred and twenty-two HCC patients who underwent elective hepatectomy in the Heze Municiple Hospital were retrospectively studied from January 1999 to December 2013.The clinical data and follow-up results were analyzed.The diagnosis of lymph node metastasis was based on preoperative imaging data and intraperative findings.Results There were 16 patients (5.0％) with lymph node metastasis (the metastasis group) and 306 patients (95.0％) without lymph node metastasis (the no-metastasis group).On Kaplan-Merier analysis,the overall survival (OS) rates at 1,2,5 years were 43.8％,31.3％,7.5％ in the metastasis group and 83.7％,70.9％,46.1％ in the no-metastasis group,respectively (Log-rank test:P ＜ 0.05).The corresponding disease-free survival (DFS) rates were 30.0％,22.5％,6.3％ in the metastasis group and 69.8％,52.8％,34.5％ in the no-metastasis group,respectively,(P ＜0.05).On follow-up,the mid-and shortterm HCC recurrence rates (≤6 months) were 71.4％ in the metastasis group (10 patients) and 31.6％ in the no-metastasis group (142 patients,x2 =9.754,P ＜ 0.05),respectively.Absence of cirrhosis,hepatectomy extent of ＞ 1 Section,max-diameter of tumor ＞ 5 cm,poor differentiation and absence of tumor encapsulation were significant factors of DFS in the metastasis group (P ＜ 0.05).On COX regression analysis,absence of tumor encapsulation was the only independent risk factor of DFS.Conclusions Regional lymph node metastasis was one of the significant factors for OS and DFS in HCC patients who underwent hepatectomy.Resection of metastatic lymph nodes and post-operation adjuvant treatment should be helpful to improve patients' prognosis.
