原发性肝细胞癌根治性切除术后肝外复发的危险因素分析

目的 探讨影响原发性肝细胞癌(hepatocelluar carcinoma,HCC)根治性切除术后肝外复发的危险因素.方法 回顾性分析行根治性切除的238例HCC患者的临床资料,确定影响术后肝外复发的危险因素.结果 本组患者随访7-78个月,随访中位时间为34个月,32例(13.4%)出现肝外复发.依据单因素分析结果,术前血清甲胎蛋白(α fetoprotein,AFP)>1000 ng/ml、天冬氨酸氨基转移酶>50 IU/L、肝静脉侵犯、周围脏器侵犯、子灶、肿瘤包膜缺失是HCC根治性切除术后肝外复发的危险因素.多因素分析显示血清AFP>1000 ng/ml、肝静脉侵犯、周围脏器侵犯是肝外复发的独立危险因素.结论 HCC根治性切除术后肝外复发与术前血清AFP>1000 ng/ml、肝静脉侵犯、周围脏器侵犯有关.对具有这些危险因素的患者术后应加强随访.

Extrahepatic recurrence after curative resection of hepatocellular cancer

Objective To investigate the risk factors of extrahepatie recurrences after curative resection of primary hepatocellular carcinoma (HCC). Methods Clinicopathologic data of 238 curative resected cases of primary HCC were retrospectively reviewed for parameters affecting postoperative extrahepatic recurrences. Results During a median follow-up of 34 months (7 - 78 months), extrahepatic recurrences were observed in 32 out of 238 patients (13.4%). According to univariate analysis, the risk factors for extrahepatic recurrences were preoperative serum a-fetoprotein (AFP) level of > 1000 ng/ml,aspartate aminotransferase level of > 50 IU/L, presence of hepatic vein invasion, neighboring organ invasion, tumor satellites, and lack of tumor capsule formation. Preoperative serum AFP levels of > 1000 ng/ml, hepatic vein invasion, neighboring organ invasion proved to be independent risk factors by multivariate analysis. Conclusions Extrahepatic recurrences after curative resection of HCC was found to be related to preoperative serum AFP level of > 1000 ng/ml, hepatic vein invasion, and neighboring organ invasion.