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首页> 外文期刊>World Journal of Gastroenterology >Risk factors for immediate post-operative fatal recurrence after curative resection of hepatocellular carcinoma.
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Risk factors for immediate post-operative fatal recurrence after curative resection of hepatocellular carcinoma.

机译：肝细胞癌根治性切除术后立即致命死亡的危险因素。

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AIM: To investigate the clinicopathological risk factors for immediate post-operative fatal recurrence of hepatocellular carcinoma (HCC), which may have practical implication and contribute to establishing high risk patients for pre- or post-operative preventive measures against HCC recurrence. METHODS: From June 1994 to May 2004, 269 patients who received curative resection for HCC were reviewed. Of these patients, those who demonstrated diffuse intra-hepatic or multiple systemic recurrent lesions within 6 mo after surgery were investigated (fatal recurrence group). The remaining patients were designated as the control group, and the two groups were compared for clinicopathologic risk factors. RESULTS: Among the 269 patients reviewed, 30 patients were enrolled in the fatal recurrence group. Among the latter, 20 patients showed diffuse intra-hepatic recurrence type and 10 showed multiple systemic recurrence type. Multivariate analysis between the fatal recurrence group and control group showed that pre-operative serum alpha-fetoprotein (AFP) level was greater than 1,000 microg/L (P = 0.02; odds ratio = 2.98), tumor size greater than 6.5 cm (P = 0.03; OR = 2.98), and presence of microvascular invasion (P = 0.01; OR = 4.89) were the risk factors in the fatal recurrence group. The 48.1% of the patients who had all the three risk factors and the 22% of those who had two risk factors experienced fatal recurrence within 6 mo after surgery. CONCLUSION: Three distinct risk factors for immediate post-operative fatal recurrence of HCC after curative resection are pre-operative serum AFP level > 1,000 microg/L, tumor size > 6.5 cm, and microvascular invasion. The high risk patients with two or more risk factors should be the candidates for various adjuvant clinical trials.
机译：目的：探讨导致肝细胞癌（HCC）术后立即致命死亡的临床病理危险因素，这可能具有实际意义，并有助于建立高危患者以预防HCC复发。方法：自1994年6月至2004年5月，对269例接受肝癌根治性切除术的患者进行了回顾。在这些患者中，对那些在术后6个月内表现出弥漫性肝内或多发性系统性复发病变的患者进行了调查（致命复发组）。将其余患者指定为对照组，并比较两组的临床病理危险因素。结果：在所审查的269例患者中，有30例患者进入了致命复发组。在后者中，20例表现为弥漫性肝内复发型，10例表现为多系统性复发型。致命复发组和对照组之间的多变量分析显示，术前血清甲胎蛋白（AFP）水平大于1,000 microg / L（P = 0.02；优势比= 2.98），肿瘤大小大于6.5 cm（P =致命复发组的危险因素为0.03； OR = 2.98），并且存在微血管浸润（P = 0.01； OR = 4.89）。具有全部三种危险因素的患者中有48.1％的患者具有两种危险因素的患者中有22％在术后6个月内出现致命复发。结论：根治性切除术后HCC术后立即致命死亡的三个明显危险因素是术前血清AFP水平> 1,000 microg / L，肿瘤大小> 6.5 cm和微血管浸润。具有两个或更多危险因素的高危患者应成为各种辅助临床试验的候选人。

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