原发性肝癌手术预后的多因素分析

目的 探索影响原发性肝癌手术预后的因素。方法 １９８８年至１９９５年手术切除原发性肝癌１８２例,从一般情况、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２０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４３．３％,获根治者（ｎ＝１５６）５生存率和无瘤生存率分别为４８．０％和２４．９％。多因素分析表明肝癌根治分类和分化程度是与生存率有显著相关性因素,两项均优者５年生存率为

Multivariate analysis of prognostic factors after hepatectomy for primary liver cancer

OBJECTIVE: To determine the prognostic factors for primary liver cancer (PLC) after hepatectomy. METHODS: 182 patients who underwent hepatectomy for PLC from 1988 to 1996 were included for univariate and Cox multivariate analysis. 20 factors contributed to the long-term survival rate (SR) and the disease-free SR were analysed. RESULTS: The cumulative SR (n = 182) in 5 years was 43.3%. The 5-year SR and disease-free SR in the curative resection (CR) group (n = 156) were 48.0%, 24.9%, respectively. Multivariate analysis revealed that classification of CR and differentiation grade were significant factors for the long-term SR, and classification of CR and Child-Pugh's classification were significant factors for the disease-free SR. The 5-year SR and disease-free SR for pathological CR, clinical CR and non-CR (palliative resection) groups were 61.1%, 20.4%, 0 and 28.8%, 15.5%, 0, respectively. CONCLUSIONS: The classification of CR is the determining prognostic factor. Pathological CR is the first option for patients with requirements. To control liver disease and improve adjuvant therapy are essential to decreasing the recurrence and metastasis rates.