MVI严重程度分级对早期肝细胞癌腹腔镜肝切除术后长期疗效的影响：一项多中心研究。

IF 2.7 3区医学 Q1 SURGERY

American journal of surgery Pub Date : 2024-09-24 DOI:10.1016/j.amjsurg.2024.115988

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引用次数: 0

摘要

目的：研究接受腹腔镜肝切除术（LLR）的早期肝细胞癌（HCC）患者微血管侵犯（MVI）分级严重程度与长期预后之间的关系：方法：研究对象为接受腹腔镜肝切除术（LLR）的早期肝细胞癌患者。根据MVI的分级严重程度，将患者分为M0、M1和M2。比较各组的无复发生存率（RFS）和总生存率（OS）。进行单变量和多变量Cox回归分析，以确定OS和RFS的独立风险因素：在233例患者中，MVI分级为M0、M1和M2的患者分别为122例（52.4%）、84例（36%）和27例（11.6%）。M0、M1和M2患者的中位OS和RFS分别为84.9、40.1和25.2个月；76.9、27.0和18.8个月。多变量分析发现，M1和M2是影响OS和RFS的独立危险因素：结论：MVI的严重程度分级与早期HCC LLR后的RFS和OS密切相关。MVI患者，尤其是M2患者，应接受严格的复发监测和积极的辅助治疗。

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Grading severity of MVI impacts long-term outcomes after laparoscopic liver resection for early-stage hepatocellular carcinoma: A multicenter study

Purpose

To examine the relationship between microvascular invasion (MVI) grading severity and long-term outcomes in early-stage hepatocellular carcinoma (HCC) patients undergoing laparoscopic liver resection (LLR).

Methods

Patients who had LLR for early-stage HCC were enrolled. According to the grading severity of MVI, patients were classified into M0, M1 and M2. Recurrence-free survival (RFS) and overall survival (OS) among the groups were compared. Univariate and multivariate Cox regression analyses were performed to identify independent risk factors of OS and RFS.

Results

Among 233 patients, MVI grading as M0, M1, and M2 accounts for 122 (52.4 %), 84 (36 %), and 27 (11.6 %) patients, respectively. The median OS and RFS in patients with M0, M1, and M2 were 84.9, 40.1, and 25.2 months; and 76.9, 27.0, and 18.8 months, respectively. Multivariable analyses identified both M1 and M2 to be independent risk factors for OS and RFS.

Conclusion

Grading severity of MVI was independently associated with RFS and OS after LLR for early-stage HCC. Patients with MVI, especially those with M2, should receive stringent recurrence surveillance and active adjuvant therapy.

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来源期刊

American journal of surgery 医学-外科

CiteScore

5.00

自引率

6.70%

发文量

570

审稿时长

56 days

期刊介绍： The American Journal of Surgery® is a peer-reviewed journal designed for the general surgeon who performs abdominal, cancer, vascular, head and neck, breast, colorectal, and other forms of surgery. AJS is the official journal of 7 major surgical societies* and publishes their official papers as well as independently submitted clinical studies, editorials, reviews, brief reports, correspondence and book reviews.