摘要
目的 对影响肝细胞肝癌手术切除预后的因素进行多因素分析。方法 1986～ 1996年经手术切除的 145例肝癌患者 ,随访至 1999年底。单因素分析采用Kaplain MeierLog rank时序检验 ,多因素采用COX比例风险模型。结果 手术后 1、3、5、7、10、12年生存期分别为 75 0 %、44 4%、2 9 5 %、2 3 5 %、2 1 2 %、16 9% ;单因素分析影响预后因素为发现方式、肝癌体积、有否门静脉癌栓、卫星结节及肝癌结节数、UICC分期、手术切缘、有否复发及复发后治疗方式、是否根治性切除 ;多因素分析得出和预后有关的因素为发现方式、UICC分期、手术切缘、有否复发及复发后治疗方式、是否根治性切除。结论 肝癌的预后取决于早期诊断及治疗方式 ;UICC分期与预后相关 ,且与卫星结节、结节数、门静脉癌栓相关。 1cm以上的手术切缘 ,可明显提高切除疗效。
Objective To study the prognostic factors in patients of HCC after hepatectomy by Cox proportional hazard.Methods 145 patients operated on for HCC from 1986 to 1996 were followed up to the end of 1999. Seventeen possible factors associated with long survival were analyzed by Kaplain Meier Log rank estimation. A multivariative survival analysis of these individual variables was undertaken using the cumulative survival rate by the computer′s Cox proportional hazard. Results The overall cumulative survival rate at 1?3?5?7?10?12 years was 75 0%?44 4%?29 5%?23 5%?21 2%? and 16 9%, respectively. Results showed that the way by which a tumor was found?tumor size?portal thrombi?satellite nodule?UICC TNM stage?cutting margin?radical resection were the prognostic factors by individual variable analysis;A multivariative analysis showed that tumor finding mode?UICC stage?cutting margin?recurrence?radical resection were associated with prognosis.Conclusion The prognostic factors of HCC focused on two aspects: early diagnosis and treatment method. UICC TNM stage is most predictive for prognosis. Cutting margin of more than 1 cm is needed for long term survival.
出处
《中华普通外科杂志》
CSCD
北大核心
2001年第8期472-474,共3页
Chinese Journal of General Surgery
关键词
肝癌
肝细胞
肝切除术
预后
COX模型
肝肿瘤
Carcinoma, hepatocellular
Prognosis
Neoplasm staging
Models, statistical
