目的评估肝癌切除术后患者的条件生存率。方法 556例肝癌切除术后患者获得随访。3年条件生存率通过公式CS=S(x+3)/S(x)获得,代表患者在术后已经活过x年的条件下能够继续存活3年的概率。结果 1、3和5年总生存率分别是69.4%、36.1%和25.2%。单因素分析发现下列病理参数与生存率关联密切:肝癌分期、肿瘤分化、微血管侵犯、术中红细胞输入以及肝纤维化;多因素回归分析(COX回归)发现肝纤维化(RR=1.789;95%CI:1.046~3.059;P=0.034)、术中红细胞输入(RR=2.093;95%CI:1.252~4.746;P=0.021)以及肝癌分化(RR=0.279;95%CI:0.0752~0.936;P=0.029)是肝癌肝脏切除术后预后的独立危险因素;使用条件生存率评价,鉴于已存活1、2、3、4、5年后患者的3年条件生存率分别为38.9%、51.7%、64.4%、76.7%和78.4%。从第3年开始,肿瘤相关因素对肝癌患者长期生存的影响减弱。结论本次研究表明,以肝癌切除术时间为基点的生存率评价是动态的;条件生存率评价显示随着时间的推移,在肝癌切除术后不同变量对总体生存率的影响不是同步的。 Objective To evaluate the conditional survival rate of patients after hepatectomy. Methods 556 patients with liver cancer were followed up. The 3-year conditional survival rate is obtained from the formula CS = S (x + 3) / S (x) and represents the probability that the patient will survive for 3 years after it has survived x years. Results The overall 1,3 and 5-year overall survival rates were 69.4%, 36.1% and 25.2%, respectively. Univariate analysis found that the following pathological parameters were closely related to the survival rate: liver cancer staging, tumor differentiation, microvascular invasion, intraoperative erythrocyte import and liver fibrosis; multiple regression analysis (COX regression) found that liver fibrosis (RR = 1.789; 95% (RR = 0.279; 95% CI: 0.0752-0.936; P = 0.0342, P = 0.034), and the difference was significant 0.029) was an independent risk factor for the prognosis of liver cancer after hepatectomy. The survival rate of the patients was 38.9%, 51.7%, 64.4% respectively after the patients had been alive for 1-2, 3-4, 5 years %, 76.7% and 78.4%. From the third year, the influence of tumor related factors on the long-term survival of patients with liver cancer is weakened. Conclusion This study shows that the evaluation of survival rate based on the time of hepatocellular carcinoma resection is dynamic. The evaluation of conditional survival rate shows that the effect of different variables on overall survival rate is not synchronized with the lapse of time.