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ISSN 1001-5256 (Print)
ISSN 2097-3497 (Online)
CN 22-1108/R
Volume 37 Issue 2
Mar.  2021
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Three-year follow-up outcomes of hepatocellular carcinoma patients undergoing liver resection versus liver transplantation

DOI: 10.3969/j.issn.1001-5256.2021.02.019
  • Received Date: 2020-08-04
  • Accepted Date: 2020-09-18
  • Published Date: 2021-02-20
  •   Objective  To investigate the three-year follow-up outcomes of hepatocellular carcinoma patients undergoing liver resection (LR) versus liver transplantation (LT).  Methods  A retrospective analysis was performed for 171 patients with hepatocellular carcinoma who underwent surgical treatment in Beijing YouAn Hospital, Capital Medical University, from March 2009 to March 2014, and according to the treatment method, they were divided into LR group(n=83) and LT group(n=88). Related clinical data were compared between the two groups. The chi-square test was used for comparison of categorical data between two groups; the Kaplan-Meier survival curve and the log-rank test were used for comparison of disease-free survival and overall survival between two groups, and the Cox proportional hazards model was used for the univariate and multivariate analyses of disease-free survival and overall survival.  Results  Compared with the LR group, the LT group had a significantly higher proportion of patients with single tumor [45.78% (38/83) vs 85.23% (75/88), χ2=29.649, P < 0.001], tumor size < 3 cm [15.66% (13/83) vs 67.05% (59/88), χ2=46.383, P < 0.001], or high Child-Pugh class [9.64% (8/83) vs 26.14% (23/88), χ2=7.833, P=0.005] and a significantly lower recurrence rate of tumor [48.19%(40/83) vs 32.95%(29/88), χ2=4.121, P=0.042]. There was a significant difference in disease-free survival rate between the LR group and the LT group (46.02% vs 80.71%, P=0.006); the LT group had a higher overall survival rate than the LR group (86.99% vs 76.44%, P=0.219). Both univariate and multivariate analyses showed that treatment method was an independent risk factor for disease-free survival (risk ratio [RR] =3.383, 95% confidence interval[CI]: 1.334-8.579;RR=0.239, 95%CI:0.093-0.612, both P < 0.05), but the prediction of overall survival by treatment method did not reach statistical significance(P=0.232).  Conclusion  LT is recommended for patients with early-stage hepatocellular carcinoma and can achieve a satisfactory three-year disease-free survival rate.

     

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  • [1]
    Bureau of Medical Administration, National Health Commission of the People's Republic of China. Guidelines for diagnosis and treatment of primary liver cancer in China (2019 edition)[J]. J Clin Hepatol, 2020, 36(2): 277-292. (in Chinese) DOI: 10.3969/j.issn.1001-5256.2020.02.007

    中华人民共和国国家卫生健康委员会医政医管局.原发性肝癌诊疗规范(2019年版)[J].临床肝胆病杂志, 2020, 36(2): 277-292. DOI: 10.3969/j.issn.1001-5256.2020.02.007
    [2]
    YANG JD, HAINAUT P, GORES GJ, et al. A global view of hepatocellular carcinoma: Trends, risk, prevention and management[J]. Nat Rev Gastroenterol Hepatol, 2019, 16(10): 589-604. DOI: 10.1038/s41575-019-0186-y
    [3]
    WAN CD, WANG GB. Advances in treatments for primary liver cancer[J]. J Abdominal Surg, 2019, 32(1): 1-6, 22. (in Chinese) http://www.cnki.com.cn/Article/CJFDTotal-FBWK201901001.htm

    万赤丹, 王国斌.原发性肝癌治疗进展[J].腹部外科, 2019, 32(1): 1-6, 22. http://www.cnki.com.cn/Article/CJFDTotal-FBWK201901001.htm
    [4]
    LIU AX, WANG HQ, BO WT, et al. Clinical efficacy and prognostic factors analysis of hepatectomy for hepatocellular carcinoma[J]. Chin J Dig Surg, 2019, 18(4): 368-374. (in Chinese) DOI: 10.3760/cma.j.issn.1673-9752.2019.04.012

    刘爱祥, 王海清, 薄文滔, 等.肝细胞癌肝切除术的临床疗效及预后因素分析[J].中华消化外科杂志, 2019, 18(4): 368-374. DOI: 10.3760/cma.j.issn.1673-9752.2019.04.012
    [5]
    LU L, QIN LX. Advances and challenges in multimodality surgical therapy for liver cancer[J]. Chin J Gen Surg, 2019, 34(11): 913-915. (in Chinese) http://d.wanfangdata.com.cn/periodical/zhptwk201911001

    陆录, 钦伦秀.肝癌外科综合治疗的进展与挑战[J].中华普通外科杂志, 2019, 34(11): 913-915. http://d.wanfangdata.com.cn/periodical/zhptwk201911001
    [6]
    AKOAD ME, POMFRET EA. Surgical resection and liver transplantation for hepatocellular carcinoma [J]. Clin Liver Dis, 2015, 19(2): 381-399. DOI: 10.1016/j.cld.2015.01.007
    [7]
    JIAO XL, CHEN Y, LI X, et al. Clinical effect of resection, radiofrequency ablation and transplantation for small hepatocellular carcinoma: Comparative study[J]. Prac J Med Pharm, 2018, 35(3): 193-196. (in Chinese) http://www.cnki.com.cn/Article/CJFDTotal-QEYY201803003.htm

    矫学黎, 陈燚, 李霞, 等.肝切除、射频消融和肝移植三种方案治疗小肝癌的临床疗效比较[J].实用医药杂志, 2018, 35(3): 193-196. http://www.cnki.com.cn/Article/CJFDTotal-QEYY201803003.htm
    [8]
    JIN ZZ, JIN FF, LIU X, et al. The association between coexistence of HBsAg/anti-HBs and risk of hepatocellular carcinoma in patients with chronic hepatitis B[J]. Beijing Med J, 2019, 41(6): 455-459. (in Chinese) http://www.cnki.com.cn/Article/CJFDTotal-BJYX201906005.htm

    金子铮, 金方方, 刘新, 等.慢性乙肝患者HBsAg/抗-HBs共存与肝癌发生风险的研究[J].北京医学, 2019, 41(6): 455-459. http://www.cnki.com.cn/Article/CJFDTotal-BJYX201906005.htm
    [9]
    SHEN JY, LI C, WEN TF, et al. Liver transplantation versus surgical resection for HCC meeting the Milan criteria: A propensity score analysis [J]. Medicine (Baltimore), 2016, 95(52): e5756. DOI: 10.1097/MD.0000000000005756
    [10]
    MENAHEM B, LUBRANO J, DUVOUX C, et al. Liver transplantation versus liver resection for hepatocellular carcinoma in intention to treat: An attempt to perform an ideal meta-analysis[J]. Liver Transpl, 2017, 23(6): 836-844. DOI: 10.1002/lt.24758
    [11]
    PINNA AD, YANG T, MAZZAFERRO V, et al. Liver transplantation and hepatic resection can achieve cure for hepatocellular carcinoma [J]. Ann Surg, 2018, 268(5): 868-875. DOI: 10.1097/SLA.0000000000002889
    [12]
    XIA YJ, JIANG Y, CAI QC, et al. Comparison of efficacies of hepatectomy and liver transplantation for patients with hepatocellular carcinoma fulfilling the Milan criteria[J]. Chin J Dig Surg, 2012, 11(6): 526-529.(in Chinese) DOI: 10.3760/cma.j.issn.1673-9752.2012.06.009

    夏玉健, 江艺, 蔡秋程, 等.肝切除和肝移植治疗符合米兰标准肝癌患者的疗效比较[J].中华消化外科杂志, 2012, 11(6): 526-529. DOI: 10.3760/cma.j.issn.1673-9752.2012.06.009
    [13]
    WANG ZS, LI N, LIN DD, et al. Research advances in the association between quality of life and osteoporosis in patients after liver transplantation[J]. Beijing Med J, 2015, 37(9): 876-878. (in Chinese) http://www.cnki.com.cn/Article/CJFDTotal-BJYX201509021.htm

    王振顺, 李宁, 林栋栋, 等.肝移植术后患者生存质量与骨质疏松关系的研究进展[J].北京医学, 2015, 37(9): 876-878. http://www.cnki.com.cn/Article/CJFDTotal-BJYX201509021.htm
    [14]
    CHEN QY, JIANG SF, XIA RP, et al. Research progress on immunosuppressants and new drugs for liver transplantation[J]. Organ Transplantation, 2020, 11(6): 663-670. (in Chinese) DOI: 10.3969/j.issn.1674-7445.2020.06.003

    陈泉余, 蒋师放, 夏仁培, 等.肝移植临床免疫抑制剂及新药研究进展[J].器官移植, 2020, 11(6): 663-670. DOI: 10.3969/j.issn.1674-7445.2020.06.003
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