간세포암의 근치적 간절제술 후 장기생존과 연관된 예후인자 (Longterm Prognostic Factors after Hepatic Resection for Hepatocellular Carcinoma)

서지정보

· 발행기관 : 대한외과학회
· 수록지 정보 : Annals of Surgical Treatment and Research / 76권 / 4호 / 225 ~ 230페이지
· 저자명 : 노무정, 김홍진, 윤성수, 이동식, 배정민

초록

Purpose: Although advancement in treatment and diagnostic tools related to hepatocelluar carcinoma has been much improved, long term survival rates of hepatocellular carcinoma are still low because of delayed clinical manifestations and underlying diseases causing the cancer. Various kinds of modalities to treat hepatocellular carcinoma have developed but surgical resection is still recognized as the best method. Therefore, we studied the associated factors of long-term survival after liver resection.
Methods: We retrospectively analyzed 184 patients who were pathologically diagnosed with hepatocellular carcinoma from May 1990 to December 2002. Associated factors of long-term survival classified as preoperative, operative, pathological and recurrence factors. Univariate and multivariate analyses were done using cross tabulation analysis and logistic regression analysis.
Results: The cumulative 1 , 3 and 5 year survival rates were 66%, 50% and 30%, respectively. Preoperative factors, significantly associated with long-term survival, were age of 60 years and under, tumor size, HBe Ag status and preoperative tumor marker level. As pathological factors, the vascular invasion and lymphatic invasion status were significantly associated. But cirrhosis of the liver was not associated with long-term survival. And in cases of recurrence, patients who had undergone repeat resection survived significantly longer.
Conclusion: The most significant factors of multivariate analyses were lymphatic invasion status. Tumor size, ICG˗R15 and HBe Ag status followed second. We should correct the preoperative factors through screening and early diagnosis. And when recurrence occurs, if the recurring cancer has resectability, repeat hepatectomy will increase the patient's lifespan.

영어초록

Purpose: Although advancement in treatment and diagnostic tools related to hepatocelluar carcinoma has been much improved, long term survival rates of hepatocellular carcinoma are still low because of delayed clinical manifestations and underlying diseases causing the cancer. Various kinds of modalities to treat hepatocellular carcinoma have developed but surgical resection is still recognized as the best method. Therefore, we studied the associated factors of long-term survival after liver resection.
Methods: We retrospectively analyzed 184 patients who were pathologically diagnosed with hepatocellular carcinoma from May 1990 to December 2002. Associated factors of long-term survival classified as preoperative, operative, pathological and recurrence factors. Univariate and multivariate analyses were done using cross tabulation analysis and logistic regression analysis.
Results: The cumulative 1 , 3 and 5 year survival rates were 66%, 50% and 30%, respectively. Preoperative factors, significantly associated with long-term survival, were age of 60 years and under, tumor size, HBe Ag status and preoperative tumor marker level. As pathological factors, the vascular invasion and lymphatic invasion status were significantly associated. But cirrhosis of the liver was not associated with long-term survival. And in cases of recurrence, patients who had undergone repeat resection survived significantly longer.
Conclusion: The most significant factors of multivariate analyses were lymphatic invasion status. Tumor size, ICG˗R15 and HBe Ag status followed second. We should correct the preoperative factors through screening and early diagnosis. And when recurrence occurs, if the recurring cancer has resectability, repeat hepatectomy will increase the patient's lifespan.

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