JAMA Surg:肝癌患者术后晚期复发的影响因素研究

2018-11-14 zhangfan MedSci原创

研究认为肝癌切除术后的晚期复发与性别、肝硬化和原发性肝癌的多个侵袭性肿瘤特征有关,积极的术后监测有助于提高晚期复发人群的生存率

一般认为肝细胞癌(HCC)切除后的晚期复发(2年以上)是由于多中心肿瘤或新生癌造成的,研究人员就HCC切除后晚期复发的相关因素进行了考察。

研究人员收集了2001-15年间,中国6家医院的HCC患者资料,其中734人在术后2年无疾病复发,303人出现晚期复发。研究的主要终点为晚期复发的风险因素、晚期复发患者的模式、治疗和长期预后。

患者平均年龄51岁,男性占88.8%。平均随访78.0个月,303人(41.3%)出现晚期复发。多因素分析显示,男性、肝硬化、多个肿瘤、卫星结节、5厘米以上肿瘤以及宏观或微观血管侵犯与晚期复发独立相关。在晚期复发人群中,273人(90.1%)仅肝内复发,30人(9.9%)肝外复发,无仅肝外复发人群。复发人群中有165例(54.5%)接受了治疗,包括再次切除、移植和局部消融。多因素COX分析显示,定期术后复查(HR=0.47)、肝硬化(1.38)、门静脉高压(2.42)、Child-Pugh等级B或C(1.37)、巴塞罗那临床肝癌B(1.304)或C(2.037)期以及后续治疗(0.443)是晚期复发人群生存期的独立影响因素。

研究认为肝癌切除术后的晚期复发与性别、肝硬化和原发性肝癌的多个侵袭性肿瘤特征有关,积极的术后监测有助于提高晚期复发人群的生存率。

原始出处:


本文系梅斯医学(MedSci)原创编译整理,转载需授权!

版权声明:
本网站所有内容来源注明为“梅斯医学”或“MedSci原创”的文字、图片和音视频资料,版权均属于梅斯医学所有。非经授权,任何媒体、网站或个人不得转载,授权转载时须注明来源为“梅斯医学”。其它来源的文章系转载文章,或“梅斯号”自媒体发布的文章,仅系出于传递更多信息之目的,本站仅负责审核内容合规,其内容不代表本站立场,本站不负责内容的准确性和版权。如果存在侵权、或不希望被转载的媒体或个人可与我们联系,我们将立即进行删除处理。
在此留言
评论区 (4)
#插入话题
  1. [GetPortalCommentsPageByObjectIdResponse(id=1969020, encodeId=75df196902087, content=<a href='/topic/show?id=4dd7812e8f3' target=_blank style='color:#2F92EE;'>#肝癌患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=81278, encryptionId=4dd7812e8f3, topicName=肝癌患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3609256, createdName=zhu_jun9837, createdTime=Wed Jun 12 13:46:00 CST 2019, time=2019-06-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1465580, encodeId=eba81465580f7, content=<a href='/topic/show?id=144f5032688' target=_blank style='color:#2F92EE;'>#影响因素#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=50326, encryptionId=144f5032688, topicName=影响因素)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=80a06745918, createdName=chenzhuanggui, createdTime=Fri Nov 16 05:46:00 CST 2018, time=2018-11-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=352700, encodeId=927a352e003e, content=66666666, beContent=null, objectType=article, channel=null, level=null, likeNumber=58, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2019/10/16/49f6165b745252a2ee92bb6d323beb1f.jpg, createdBy=93352484066, createdName=alimm, createdTime=Thu Nov 15 21:28:06 CST 2018, time=2018-11-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=352584, encodeId=ba83352584b8, content=回顾性研究,但是有长期随访结果很难得。这是肝癌术后生存的关键研究, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c4a5105539, createdName=lovetcm, createdTime=Wed Nov 14 15:45:34 CST 2018, time=2018-11-14, status=1, ipAttribution=)]
  2. [GetPortalCommentsPageByObjectIdResponse(id=1969020, encodeId=75df196902087, content=<a href='/topic/show?id=4dd7812e8f3' target=_blank style='color:#2F92EE;'>#肝癌患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=81278, encryptionId=4dd7812e8f3, topicName=肝癌患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3609256, createdName=zhu_jun9837, createdTime=Wed Jun 12 13:46:00 CST 2019, time=2019-06-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1465580, encodeId=eba81465580f7, content=<a href='/topic/show?id=144f5032688' target=_blank style='color:#2F92EE;'>#影响因素#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=50326, encryptionId=144f5032688, topicName=影响因素)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=80a06745918, createdName=chenzhuanggui, createdTime=Fri Nov 16 05:46:00 CST 2018, time=2018-11-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=352700, encodeId=927a352e003e, content=66666666, beContent=null, objectType=article, channel=null, level=null, likeNumber=58, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2019/10/16/49f6165b745252a2ee92bb6d323beb1f.jpg, createdBy=93352484066, createdName=alimm, createdTime=Thu Nov 15 21:28:06 CST 2018, time=2018-11-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=352584, encodeId=ba83352584b8, content=回顾性研究,但是有长期随访结果很难得。这是肝癌术后生存的关键研究, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c4a5105539, createdName=lovetcm, createdTime=Wed Nov 14 15:45:34 CST 2018, time=2018-11-14, status=1, ipAttribution=)]
  3. [GetPortalCommentsPageByObjectIdResponse(id=1969020, encodeId=75df196902087, content=<a href='/topic/show?id=4dd7812e8f3' target=_blank style='color:#2F92EE;'>#肝癌患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=81278, encryptionId=4dd7812e8f3, topicName=肝癌患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3609256, createdName=zhu_jun9837, createdTime=Wed Jun 12 13:46:00 CST 2019, time=2019-06-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1465580, encodeId=eba81465580f7, content=<a href='/topic/show?id=144f5032688' target=_blank style='color:#2F92EE;'>#影响因素#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=50326, encryptionId=144f5032688, topicName=影响因素)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=80a06745918, createdName=chenzhuanggui, createdTime=Fri Nov 16 05:46:00 CST 2018, time=2018-11-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=352700, encodeId=927a352e003e, content=66666666, beContent=null, objectType=article, channel=null, level=null, likeNumber=58, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2019/10/16/49f6165b745252a2ee92bb6d323beb1f.jpg, createdBy=93352484066, createdName=alimm, createdTime=Thu Nov 15 21:28:06 CST 2018, time=2018-11-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=352584, encodeId=ba83352584b8, content=回顾性研究,但是有长期随访结果很难得。这是肝癌术后生存的关键研究, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c4a5105539, createdName=lovetcm, createdTime=Wed Nov 14 15:45:34 CST 2018, time=2018-11-14, status=1, ipAttribution=)]
    2018-11-15 alimm

    66666666

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=1969020, encodeId=75df196902087, content=<a href='/topic/show?id=4dd7812e8f3' target=_blank style='color:#2F92EE;'>#肝癌患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=81278, encryptionId=4dd7812e8f3, topicName=肝癌患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3609256, createdName=zhu_jun9837, createdTime=Wed Jun 12 13:46:00 CST 2019, time=2019-06-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1465580, encodeId=eba81465580f7, content=<a href='/topic/show?id=144f5032688' target=_blank style='color:#2F92EE;'>#影响因素#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=50326, encryptionId=144f5032688, topicName=影响因素)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=80a06745918, createdName=chenzhuanggui, createdTime=Fri Nov 16 05:46:00 CST 2018, time=2018-11-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=352700, encodeId=927a352e003e, content=66666666, beContent=null, objectType=article, channel=null, level=null, likeNumber=58, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2019/10/16/49f6165b745252a2ee92bb6d323beb1f.jpg, createdBy=93352484066, createdName=alimm, createdTime=Thu Nov 15 21:28:06 CST 2018, time=2018-11-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=352584, encodeId=ba83352584b8, content=回顾性研究,但是有长期随访结果很难得。这是肝癌术后生存的关键研究, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c4a5105539, createdName=lovetcm, createdTime=Wed Nov 14 15:45:34 CST 2018, time=2018-11-14, status=1, ipAttribution=)]
    2018-11-14 lovetcm

    回顾性研究,但是有长期随访结果很难得。这是肝癌术后生存的关键研究

    0

相关资讯

NAT REV DRUG DISCOV:肝癌的治疗现状与未来

免疫疗法将在5年内有望成为治疗肝癌的第一大疗法,给全世界的肝癌患者带来新的治疗方案。

治肝防癌,一生一试:预防肝癌术后复发值得一试

2007年体检时发现HBsAg阳性,查肝功正常,不伴纳差、乏力等症状。未治疗,定期复查。2012年复查肝功能异常,给予抗病毒药物阿德福韦酯,服用3年经医生同意停药,停药后定期复查肝功能及HBV DNA、甲胎蛋白(AFP)均正常。2016年3月以“慢乙肝,肝癌(HCC)”入院治疗。

Hepatology:中科大田志刚教授团队揭示以天然免疫为主导的HBV相关肝癌发病机制

最近,肝病权威学术期刊Hepatology杂志在线发表了中国科技大学生命科学院田志刚教授团队的研究成果,揭示了天然免疫应答在HBV相关肝细胞癌(HCC)发生中的重要作用。

Nat Commun:刷新认知!生物钟竟可阻止肝癌进展!

近日,由来自休斯顿德克萨斯大学健康科学中心(UTHealth)的研究人员发现,体内生物钟竟然对抑制肝癌具有显着作用。他们发现在50%的肝癌组织中会出现一种功能失调的蛋白,而这种蛋白又可诱导机体生物钟功能障碍,该研究的最新进展发表于最新的《Nature Communications》杂志。让我们来看看生物钟与肝癌究竟是如何相互影响的。

Cell:膳食纤维竟能诱发肝癌?专家称:天然膳食纤维可放心吃!

近些年来,膳食纤维备受追捧,但10月18日一篇发表在《细胞》杂志上的文章却让人跌破眼镜:膳食纤维竟然能够诱发肝癌?

Cell:刷新认知!肥胖竟会导致肝癌!

我们所了解的是肥胖会导致脂肪肝,脂肪肝演变成肝硬化,而肝硬化又很可能恶化为肝癌。我们所不知道的是,肥胖的真正可怕之处在于“不走寻常路”,其更多的是通过诱发非NAFLD(非酒精性脂肪性肝病)途径而导致肝癌发生发展