Risk factor analysis of recurrent hepatocellular carcinoma with portal vein tumor thrombus
10.19538/j.cjps.issn1005-2208.2019.06.20
- Author:
Si-yu MU
1
;
Yang XIN
1
;
Tian-xiang LI
1
Author Information
1. Department of Hepatobiliary and Pancreatic Surgery, Affiliated Hospital of Qingdao University Qingdao 266000, China
- Publication Type:Journal Article
- Keywords:
recurrent hepatocellular carcinoma;
portal vein tumor thrombus;
risk factor
- From:
Chinese Journal of Practical Surgery
2019;39(06):610-614
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE: To investigate the effect of clinicopathological factors on the recurrent hepatocellular carcinoma(HCC)with portal vein tumor thrombus(PVTT)after radical resection.METHODS: The data of patients with HCC who underwent radical resection between January 2000 and December 2014 in Affiliated Hospital of Qingdao University were analyzed retrospectively.Clinical and pathological data from first resection to the recurrence of HCC with PVTT were extracted in the form of data tables.All patients were divided into PVTT group and non PVTT group according to the occurence of PVTT at time of HCC recurrence,and the risk factors of PVTT formation were analyzed.Risk factors influencing the formation time,from radical resection to HCC recurrence,were analyzed in recurrent HCC patients with PVTT.RESULTS: Univariate analysis results showed that patients having HCC with multiple tumors,no tumor capsule,and Child-pugh B grade had a high proportion of PVTT when HCC recurred.The results of logistic regression analysis showed that multiple tumors,no tumor capsule,and Childpugh B grade were independent risk factors for PVTT formation after radical resection of HCCA predictive model was established on the basis of the three risk factors(1 point for each factor).ROC curve showed the total model score has certain predictive value.The area under the curve was 0.662(P=0.003,95% CI:0.557-0.766),cut-off value was 0.5 points,Youden index was 0.302(sensitivity=60.0%,specificity=70.2%).The higher the model score,the shorter the tumor-free survival time(P=0.007),and the higher the incidence of PVTT recurrence(P=0.001).The results of Kaplan-Meier(log-rank test)and multivariate analysis of Cox regression model showed that lower differentiation of HCC was an independent risk factor influencing the time from radical resection to HCC recurrence with PVTT(P=0.000). CONCLUSION: Patients with multiple tumor foci,no tumor capsule and Child grade B grade liver cancer are more likely to recur with PVTT after RO operation.And among them,the low differentiation of liver cancer grows faster.A closer follow-up or preventive treatment of patients with high-risk factors may improve prognosis.
