论文部分内容阅读
目的探讨BCLC B期肝癌患者进行手术治疗的预后及危险因素。方法回顾性分析经手术治疗的805例BCLC A期和B期肝癌患者的临床资料及预后情况,对比BCLC A期及BCLC B期患者的预后差异,应用Kaplan-Meier法及Cox回归法分析BCLC B期患者的生存相关因素,并对相关因素进行危险分级。结果 365例BCLC B期肝癌患者中位随访时间为26.0个月(2.0~135.0个月);中位生存时间为50.8个月,1、3、5年生存率分别为76%、54%和40%;中位无病生存时间为25.8月,1、3、5年无病生存率分别为53%、38%和31%。单因素分析提示脉管瘤栓、肿瘤多发、术中出血≥400 ml为患者总生存时间的预后不良因素;肿瘤多发、术中出血≥400 ml是患者无病生存时间的危险因素。多因素分析显示术中出血≥400 ml是影响BCLC B期患者总生存时间及无病生存时间的独立危险因素。结论大部分BCLC B期肝癌患者能够从手术治疗中获益,术中出血≥400 ml是提示预后不良的独立危险因素。
Objective To investigate the prognosis and risk factors of surgical treatment of patients with BCLC stage B liver cancer. Methods The clinical data and prognosis of 805 patients with BCLC stage A and B liver cancer were retrospectively analyzed. The prognostic differences between BCLC stage A and BCLC stage B patients were compared. Kaplan-Meier method and Cox regression were used to analyze BCLC B Patients with survival-related factors, and related factors for risk classification. Results The median follow-up time of 365 patients with BCLC stage B hepatocellular carcinoma was 26.0 months (2.0-135.0 months). The median survival time was 50.8 months. The 1,3 and 5-year survival rates were 76%, 54% and 40%, respectively %; Median disease-free survival time was 25.8 months, 1,3 and 5 year disease-free survival rates were 53%, 38% and 31%. Univariate analysis showed that the tumor thrombus, tumor multiple, intraoperative bleeding ≥ 400 ml prognosis of patients with poor prognosis factors; multiple tumor, bleeding ≥ 400 ml is a risk-free survival of patients with risk factors. Multivariate analysis showed that intraoperative blood loss≥400 ml was an independent risk factor for overall survival and disease-free survival in patients with BCLC B stage. Conclusions Most of the patients with BCLC stage B liver cancer can benefit from surgical treatment. Intraoperative bleeding≥400 ml is an independent risk factor for poor prognosis.