Analysis on factors influencing one-year-survival of hepatocellular carcinoma patients after hepatectomy / 中华普通外科杂志

ABSTRACT

Objective To analyze the factors that influence the survival condition during the first year after hepatectomy in patients with hepatocellular carcinoma (HCC). Methods Five hundred twentyeight HCC cases undergoing hepatectomy were included from January 1997 to December 2008.The factors and survival outcomes in these patients were analyzed. Results There were 302 patients dying during a medium follow-up of 35 months and 1-year cumulative survival was 85％.The causes of death during first year were tumor recurrence (78.1％,75/96) and liver dyscompensation ( 19.8％,19/96).By Cox regression analysis,tumor size ≥5 cm (P =0.047 ),vascular invasion ( P =0.018),histologic moderately and poorly differentiation ( P =0.001 ) and pathologically positive margin ( P =0.004 ) were significantly associated with tumor recurrence,and portal hypertension was an independent factor for patients dying from liver dysfunction ( P =0.001 ).Positive tumor margin was the most important factor associated with postoperative death within one year (59.3％,60/96). Conclusions During the first year after HCC resection,tumor recurrence and liver dysfunction are main factors influencing HCC patients' survival,nonR0 resection is the main factor causing tumor recurrence,and portal hypertension is an independent factor for patients dying of liver dyscompensation.