Các yếu tố tiên lượng tái phát sau phẫu thuật cắt gan điều trị ung thư biểu mô tế bào gan

Abstract

Objective: To analyze several factors affecting recurrence and disease-free survival (DFS) in patients with hepatocellular carcinoma (HCC) of whom liver resection was first treatment. Subject and method: 1704 HCC patients who underwent liver resection as first treatment at Liver Tumor Department, Cho Ray Hospital, Ho Chi Minh City, Vietnam between January 2015 and December 2019 were enrolled in a retrospective study. Those patients were followed up until June 2021, with follow-up time is at least 18 months and at most 78 months. The prognostic significance of viral infection, AFP level, and various pathological factors were evaluated by univariate analysis using the log-rank test and by multivariate analysis using the Cox proportional-hazards regression to determine the related factors affecting DFS and by logistic regression model to determine the factors affecting recurrence. Result: Univariate analysis showed that AFP level, vascular invasion, tumor number, tumor size, histological pattern, Edmonson-Steiner staging, tumor necrosis, accompanying resectable metastatic tumors, resection level are related to recurrence and DFS, while underlying liver disease is only related to DFS. Logistic regression model showed that AFP level, vascular invasion, tumor number, tumor size, accompanying resectable metastatic tumors are independent prognostic factors for recurrence. Multivariate analysis using the Cox proportional-hazards regression showed that tumor number and accompanying resectable metastatic tumors were independent prognostic factors for DFS. Conclusion: For HCC patients who received liver resection as first treatment, AFP level, tumor number, tumor size, histological pattern, Edmonson-Steiner staging, tumor necrosis, vascular invasion, accompanying resectable metastatic tumors, resection level are related to recurrence and DFS. Underlying liver disease is related to DFS. Viral infection is not related to recurrence and DFS.