A Long-Term Follow-Up and Comprehensive Observation of Risk and Prognosis Factors of Recurrence and Survival After Resection of Hepatocellular Carcinoma

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• 作者：Lei Hu (1)
  Feng Xue (1)
  Yunyun Li (2)
  Minhua Shao (3)
  Yanfu Sun (1)
  Gongtian Wei (1)
  
• 关键词：Hepatocellular carcinoma ; Prognosis ; Overall survival ; Disease ; free survival
• 刊名：Cell Biochemistry and Biophysics
• 出版年：2014
• 出版时间：July 2014
• 年：2014
• 卷：69
• 期：3
• 页码：421-431
• 全文大小：
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• 作者单位：Lei Hu (1)
  Feng Xue (1)
  Yunyun Li (2)
  Minhua Shao (3)
  Yanfu Sun (1)
  Gongtian Wei (1)
  
  1. The Second Department of Liver Surgery, Eastern Hepatobiliary Hospital Affiliated to the Second Military Medicine College, Shanghai, China
  2. The Fourth Department of Liver Surgery, Eastern Hepatobiliary Hospital Affiliated to the Second Military Medicine College, Shanghai, China
  3. Department of Pulmonary Medicine, Shanghai Chest Hospital, Affiliated to Jiaotong University, Shanghai, China
  
• ISSN：1559-0283

文摘

Although HBV, liver function and tumor characteristics were proven as hepatocellular carcinoma (HCC) prognosis-related, no large-scale and long-term follow-up studies have ever given robust evidence about prognosis predictive effect and contribution to different stage of postoperation. In this study, we evaluated the influence of above index on overall survival (OS) and disease-free survival (DFS) and other clinical data in a rather large population and long-term follow-up. Our study consisted of 1,326 HCC patients who underwent radical resection from 1996 to 2010. Epidemiology, clinical and prognosis data were analyzed. Risk factors of OS and DFS were explored. Cumulative survival comparison between groups was performed with log-rank. Multivariate analysis for independent prognostic factors was determined by Cox proportional hazards model. HBsAg status was a universal factor of HCC recurrence, while preoperational albumin (ALB) and portal vein tumor thrombus (PVTT) affected survival during the whole lifetime. Early stage recurrence was associated with capsule intact [OR (95?%)?=?1.54,1.12-.12, p?=?0.009], preoperational alpha-fetoprotein (AFP), TNM and BCLC stages were the most important prognosis factors of recurrence in the early 5?years and PVTT affected the rest time. Survival was mainly associated with tumor characteristic and ALB. Short-time survival was affected with age and AFP, while BCLC was related with the long-time survival. We confirmed that during different periods after resection, factors affecting prognosis did not remain unchanged. Liver function and tumor characteristic affected DFS and OS the whole time, especially the early recurrence. However, HBV infection situation was associated with later recurrence. PVTT showed an opposite effect between early and later recurrence.