摘要
目的探索影响肝细胞癌根治术预后的因素。方法 1988年至1995年根治性手术切除肝细胞癌144例,从一般状况、肝病基础、肝癌临床和病理特征以及治疗措施等方面选择了19项指标,先后进行单因素和逐步 Cox 回归分析。结果全组5年生存率为47.3%,无瘤生存率为23.9%。多因素分析表明肝癌根治分类是与生存率有显著相关性的因素,病理根治者5年生存率为60.2%,临床根治者为14.0%;脉管浸润是与无瘤生存率有显著相关性的因素,无脉管浸润者5年无瘤生存率为27.8%,有脉管浸润者为0%。病理根治、临床根治两组5年无瘤生存率分别29.0%和0%。结论肝癌根治分类是影响手术预后的主要因素,为提高肝癌手术预后除强调肝癌"三早"外,应力求病理根治并进一步探索和改进辅助疗法以减少复发和转移。
Objective To determine the prognostic factors after radical resection (RR) for hepatocellular carcinoma (HCC).Methods Altogether 144 patients who had undergone RR for HCC from 1988 through 1995 were included for a univariate and a Cox multivariate analysis.Nineteen factors contributing to overall survival rate (SR) and disease-free SR were analysed.Results The 5-year SR and disease-free SR (N=144) were 47.3% and 23.9%,separately.Multivariate analysis revealed that classification of RR was the signficant factor to overall SR,and presence of vessel invasion was the signficant factor to disease-free SR.The 5-year SR and disease-free SR in the patholngically RR and clinically RR groups were 60.2%,29.0% and 14.0%,0%,respectively.The 5-year disease-free SR in the group without (or with) vessel invasion was 27.8% (or 0%).Conclusions The classification of RR is the determinative prngnostie factor.Pathologically RR is the first option for patients with in- dications.It is essential to improve adjuvant therapy to decrease postoperative recurrence and metastasis rates.
出处
《中华肝胆外科杂志》
CAS
CSCD
1998年第6期359-362,共4页
Chinese Journal of Hepatobiliary Surgery
