转换疗法后肝切除术后肝细胞癌的预后预测。

IF 3.5 2区医学 Q2 ONCOLOGY

Ejso Pub Date : 2024-11-09 DOI:10.1016/j.ejso.2024.109375

Shaoru Liu , Zongfeng Wu , Chenwei Wang , Liang Qiao , Zhenkun Huang , Yichuan Yuan , Ruhai Zou , Wei He , Binkui Li , Yunfei Yuan , Jiliang Qiu

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引用次数: 0

摘要

背景：对于不到 20% 的肝细胞癌（HCC）患者来说，肝切除术是最佳治疗方法。肝动脉灌注化疗和基于全身治疗的转换疗法相结合，为那些无法切除的 HCC 患者提供了切除的机会。然而，成功转化切除者的预后仍然未知。本研究旨在确定预测转换肝切除术后患者预后的因素：2018年8月至2023年4月，共有343名HCC患者在转换疗法后接受了肝切除术。采用单变量和多变量分析筛选影响患者预后的独立因素：157例（45.8%）患者在肝切除术后的中位时间16.7个月（95% CI 12.4-21.0个月）时出现复发或转移。单变量和多变量分析表明，肿瘤数量、甲胎蛋白（AFP）反应、肿瘤反应和成功降期是与复发无生存期相关的独立预测因素。白蛋白胆红素（ALBI）评分和甲胎蛋白反应是与死亡相关的独立预测因素：反映转化治疗反应深度的临床参数有望预测转化肝切除术后 HCC 患者的预后。

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Prognosis predictors of hepatocellular carcinoma after hepatectomy following conversion therapy

Background

Hepatectomy is the optimal treatment for less than 20 % patients with hepatocellular carcinoma (HCC). A combination of hepatic artery infusion chemotherapy and systemic therapy-based conversion therapy provides a chance of resection for those with unresectable HCC. Yet, the prognosis for those successfully conversion resection is still unknown. The study is to determine the factors predicted prognosis of patients after conversion hepatic resection.

Methods

A total of 343 HCC patients underwent hepatectomy following conversion therapy from August 2018 to April 2023. Univariate and multivariate analysis were used to screen for independent factors affecting patients’ prognosis.

Results

One hundred and fifty-seven (45.8 %) patients developed recurrence or metastasis at a median time of 16.7 months (95 % CI 12.4–21.0 months) from hepatectomy. Univariate and multivariate analysis identified tumor number, alpha fetoprotein (AFP) response, tumor response, and successful downstaging were independent recurrent-free survival related predictors. Albumin bilirubin (ALBI) score and AFP response were independent death related predictors.

Conclusions

Clinical parameters reflecting the depth of conversion therapy response, were promising in predicting prognosis for HCC patients after conversion hepatic resection.

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来源期刊

Ejso 医学-外科

CiteScore

6.40

自引率

2.60%

发文量

1148

审稿时长

41 days

期刊介绍： JSO - European Journal of Surgical Oncology ("the Journal of Cancer Surgery") is the Official Journal of the European Society of Surgical Oncology and BASO ~ the Association for Cancer Surgery. The EJSO aims to advance surgical oncology research and practice through the publication of original research articles, review articles, editorials, debates and correspondence.