手术切除治疗巨大原发性肝癌的预后因素分析  

Analysis of prognostic factors in patients with huge primary liver cancer after surgical resection

作　　者：陈中[1] 倪家连[1] 刘鲁岳[1] 

机构地区：[1]济南军区总医院肝胆外科,250031

出　　处：《中华肿瘤杂志》2011年第9期710-713,共4页Chinese Journal of Oncology

摘　　要：目的研究巨大原发性肝癌患者手术切除治疗后的预后影响因素，寻找改善巨大原发性肝癌患者预后的方法。方法回顾性分析69例手术切除治疗的巨大原发性肝癌患者的临床资料，采用Cox回归模型对16个可能与患者预后有关的因素进行统计学分析。结果58例患者获得随访，随访患者的1、3、5年生存率分别为58．2％、31．4％和12．3％。单因素分析的结果显示，有无肝内转移、有无血管侵犯、肝硬化程度和是否行根治性切除与巨大原发性肝癌手术切除治疗后患者的预后有关（均P〈0．05）。Cox多因素回归分析的结果显示，肝硬化程度、有无肝内转移和是否行根治性切除是影响巨大原发性肝癌患者手术切除治疗后预后的独立因素（均P〈0．05）。结论积极行手术切除是治疗巨大原发性肝癌的主要措施，其预后取决于是否伴有肝内转移、肝硬化程度和是否行根治性切除。Objective To analyze the prognostic factors in patients after surgical resection of a huge primary liver cancer （HPLC）. Methods Clinical and follow-up data of 69 cases of huge HPLC trerated in our hospital from July 2001 to July 2008 were retrospectively analyzed. Sixteen clinicopathologic factors possibly influencing the survival were selected, and multivariate analysis of these parameters was performed using the Cox proportional hazards model. Results The cumulative 1-, 3-, 5-year survival rates of 58 patients were 58.2%, 31.4% and 12.3%, respectively. Univariate analysis showed that radical resection, intrahepatic metastasis, vascular invasion and degree of hepatic cirrhosis significantly affect the postoperative survival. The Cox multivariate analysis indicated that radical resection, intrahepatic metastasis and degree of hepatic cirrhosis are independent prognostic factors. Conclusions Surgical resection is a major and active treatment for huge HPLC. The therapeutic efficacy depends on intrahepatic metastasis, degree of hepatic cirrhosis and radical resection. Aggressive treatment and prevention on postoperative intrahepatic recurrence and metastasis is an important strategy to improve the survival of patients with huge HPLC.

关 键 词：肝肿瘤 肝切除术 预后 

分 类 号：R735.7[医药卫生—肿瘤]