一家三级医疗中心有肝硬化或无肝硬化的新发肝细胞癌的特征和存活率比较

IF 1.4 4区医学 Q4 GASTROENTEROLOGY & HEPATOLOGY

Turkish Journal of Gastroenterology Pub Date : 2024-07-01 DOI:10.5152/tjg.2024.23451

Filiz Araz, Barış Soydaş, Birol Özer, Elif Karadeli, Gürcan Erbay

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引用次数: 0

摘要

背景/目的：尽管肝细胞癌（HCC）通常发生在肝硬化患者的肝脏中，但HCC也可能发生在非肝硬化患者的肝脏中。我们旨在比较肝硬化和非肝硬化 HCC 的特征和存活率：我们对一家三级医疗中心 2011 年至 2021 年间的 HCC 患者数据进行了回顾性评估。比较了肝硬化和非肝硬化 HCC 的人口统计学、临床、实验室、肿瘤和病理特征以及生存结果：研究纳入了 188 例 HCC 患者。中位年龄为 64（26-92）岁，各研究组的中位年龄相似（P = .208）。两组患者的男女比例相似。42名患者（22.3%）的HCC发生在非肝硬化肝脏。与非肝硬化 HCC 相比，非肝硬化 HCC 具有相似的肿瘤分化类型、放射学特征、米兰分期、加州大学旧金山分期和巴塞罗那诊所肝癌分期，但单灶病变更多（78.6% 对 59.6%），发病时肿瘤体积更大（89.5 (16-240) mm 对 59.0 (12-290) mm）。尽管肿瘤体积较大，但非肝硬化型 HCC 患者的总生存率、无病生存率和无进展生存率均优于肝硬化型 HCC 患者。非肝硬化HCC患者1年和3年的总生存率分别为71.4%和49.7%，肝硬化HCC患者1年和3年的总生存率分别为54%和28.3%（P = .035）。根据 Cox 分析，东部合作肿瘤学组评分（P 结论：东部合作肿瘤学组评分与肝癌的发病率呈正相关：尽管肿瘤体积更大且肿瘤分期相似，但与肝硬化型 HCC 相比，非肝硬化型 HCC 的生存率更高。

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Comparison of Characteristics and Survival of New-Onset Hepatocellular Carcinomas With or Without Cirrhosis in a Tertiary Center.

Background/aims: Although hepatocellular carcinoma (HCC) usually develops in cirrhotic livers, HCCs could also arise in non-cirrhotic livers. We aimed to compare the characteristics and survival of cirrhotic- and non-cirrhotic HCCs.

Materials and methods: Data of HCC patients between 2011 and 2021 in a single tertiary center was evaluated retrospectively. Demographic, clinical, laboratory, tumoral and pathological features, and survival outcomes of cirrhotic and non-cirrhotic HCCs were compared.

Results: The study included 188 HCC patients. Median age was 64 (26-92) years and similar for study groups (P = .208). Both groups had similar male/female ratio. Forty-two patients (22.3%) had HCC in non-cirrhotic liver. Non-cirrhotic HCCs had similar tumor differentiation type, radiological characteristics, Milan, University of California San Francisco, and the Barcelona Clinic Liver Cancer stages, but more unifocal lesion (78.6% vs. 59.6%) and larger tumor size (89.5 (16-240) mm vs. 59.0 (12-290) mm) at presentation compared to non-cirrhotic HCCs. Despite larger tumor size, non-cirrhotic HCC patients had better overall, disease-free and progression-free survival rates than cirrhotic HCCs. Overall survivals for 1 and 3 years were 71.4% and 49.7% for non-cirrhotic and 54% and 28.3% for cirrhotic HCCs, respectively (P = .035). According to Cox analyses, Eastern Cooperative Oncology Group score (P <.001, hazards ratio (HR): 4.05) and curative treatments (P < .001, HR: 0.21) were predictive for overall survival in cirrhotic HCCs. Curative treatment (P = .027, HR: 0.31) was found to be a significant predictor for overall survival in non-cirrhotic HCCs. Vascular invasion was the only independent predictor for disease-free survival (HR: 2.62, 95% CI 1.01-6.93, P = .049) for non-cirrhotic HCCs.

Conclusion: Despite larger tumor size and similar tumor stages, compared to cirrhotic HCCs, non-cirrhotic HCCs were associated with better survival outcomes.

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来源期刊

Turkish Journal of Gastroenterology 医学-胃肠肝病学

CiteScore

1.90

自引率

0.00%

发文量

127

审稿时长

6 months

期刊介绍： The Turkish Journal of Gastroenterology (Turk J Gastroenterol) is the double-blind peer-reviewed, open access, international publication organ of the Turkish Society of Gastroenterology. The journal is a bimonthly publication, published on January, March, May, July, September, November and its publication language is English. The Turkish Journal of Gastroenterology aims to publish international at the highest clinical and scientific level on original issues of gastroenterology and hepatology. The journal publishes original papers, review articles, case reports and letters to the editor on clinical and experimental gastroenterology and hepatology.