Análisis de supervivencia del tratamiento quirúrgico del carcinoma hepatocelular en un centro de tercer nivel

IF 1.5 Q3 GASTROENTEROLOGY & HEPATOLOGY
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Abstract

Introduction and aims

Hepatocellular carcinoma (HCC) is a primary malignant tumor of liver epithelial cells and is the most frequent primary liver cancer. The broadening of transplantation and resectability criteria has made therapeutic decisions more complex. Our aim was to describe the clinical and survival characteristics of patients with HCC treated through resection or liver transplantation at our hospital and identify the presence of factors that enable outcome prediction and facilitate therapeutic decision-making.

Materials and methods

Patients with HCC that underwent surgery with curative intent at the Hospital Universitario Marqués de Valdecilla, within the time frame of 2007 and 2017, were retrospectively identified. Survival, mortality, disease-free interval, and different outcome-related variables were analyzed.

Results

Ninety-six patients with a mean follow-up after surgery of 44 months were included. Overall mortality and recurrence were higher in the resection group. Mean survival was 51.4 months in the liver transplantation group and 37.5 months in the resection group, and the disease-free interval was 49.4 ± 37.2 and 27.4 ± 28.7 months, respectively (p = 0.002). The tumor burden score was statistically significant regarding risk for recurrence and specific mortality.

Conclusions

There appears to be no patient subgroup in whom the results of surgical resection were superior or comparable to those of transplantation. Tumor burden determination could be a useful tool for patient subclassification and help guide therapeutic decision-making.

一家三级医疗中心肝细胞癌手术治疗的存活率分析
导言和目的肝细胞癌(HCC)是肝上皮细胞的原发性恶性肿瘤,也是最常见的原发性肝癌。移植和可切除标准的扩大使治疗决策变得更加复杂。我们的目的是描述在本医院接受切除术或肝移植治疗的 HCC 患者的临床和生存特征,并确定是否存在能够预测结果和促进治疗决策的因素。材料和方法我们对 2007 年至 2017 年期间在巴尔德西亚马奎斯大学医院接受治愈性手术的 HCC 患者进行了回顾性鉴定。结果共纳入96名患者,术后平均随访44个月。切除组的总死亡率和复发率较高。肝移植组的平均生存期为 51.4 个月,切除组为 37.5 个月,无病间隔时间分别为 49.4 ± 37.2 个月和 27.4 ± 28.7 个月(P = 0.002)。肿瘤负荷评分在复发风险和特定死亡率方面具有统计学意义。结论似乎没有哪个患者亚组的手术切除效果优于或类似于移植。肿瘤负荷测定可作为患者亚分类的有用工具,并有助于指导治疗决策。
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来源期刊
Revista de Gastroenterologia de Mexico
Revista de Gastroenterologia de Mexico GASTROENTEROLOGY & HEPATOLOGY-
CiteScore
1.60
自引率
12.50%
发文量
102
审稿时长
12 weeks
期刊介绍: La Revista de Gastroenterología de México es el órgano oficial de la Asociación Mexicana de Gastroenterología. Sus espacios están abiertos a los miembros de la Asociación como a todo miembro de la comunidad médica que manifieste interés por utilizar este foro para publicar sus trabajos, cumpliendo con las políticas editoriales que a continuación se mencionan. El objetivo principal de la Revista de Gastroenterología de México, es publicar trabajos originales del amplio campo de la gastroenterología, así como proporcionar información actualizada y relevante para el área de la especialidad y áreas afines. Los trabajos científicos incluyen las áreas de Gastroenterología clínica, endoscópica, quirúrgica y pediátrica.
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