Prognosis Of122Hepatocellular Carcinoma Patients After Hepatectomy:a Multivariate Analysis

Objective:Hepatocellular carcinoma (HCC) is a common malignancy in China.Since HCC is insensitive to the radiotherapy and chemotherapy, surgical resection isone important curative treatment for HCC. However, long-term survival remainsunsatisfactory. Part of the patients underwent hepatectomy recurred at an early stage.The5-year overall survival rates for patients with HCC after operation reminds lowerthan50%. Both the domestic and foreign researches showed that many influencingfactors were revealed with the prognosis after hepatectomy. But only part of theresearches were related to multivariate analysis. Our aim in this article was to study theclinicopathological characteristics and the prognosis of hepatocellular carcinomapatients after hepatectomy.Methods:The clinical data of122hepatocellular carcinoma patients afterhepatectomy admitted in the First Affiliated Hospital of Dalian Medical University fromJanuary2002to October2013were reviewed on the medical records related43indicators such as living habit, clinicopathological features and serological indicators.With the help of the Center for Disease Control and medical record department, we gotmost information of the patients’ surviving time, and some of them were found bytelephone communication. All the patients were divided into two groups:the survivinggroup and the dead group. The COX regression model was built to analyze theindependent prognostic risk factors of the patients.Results:1.The characteristics of patients: The median survival time of all122cases was33.5months and the longest survival time of patient performed hepatectomy was144months. The overall122cases consisted of96males (78.69%) and26females (29.31%) cases ranged in age from31to79. The median patient age was48years old.50%of thepatients were found by the way of medical examination,20%of the patients were foundby the abnormal results of the tumor marker,30%of the patients were found whenhepatalgia, icterus, ascites unusual clinical symptoms emerged. All the tumor specimenswere confirmed by the department of pathology. Among them,102cases with positiveHBs-Ag status,5cases with positive HCVAb status,2cases involved HBV and HCVsuper-infection and13cases with negative HBs-Ag/HCVAb. We found87caseswith cirrhosis. There were82patients with tumor in the right liver, the rest in the left.All the patients did not get any treatment before hepatectomy. There wasn’t portal veinemboli, invasion and lymph node metastasis. Until the endpoint,45of122patients werenoted to have recurrence.2.Prognostic factors for overall survival: In the analysis, there were significantdifferences in survival within the groups stratified by gender, age, smoking, Child-Pughgrade, TNM stage, splenomegaly, tumor size, number of tumors, capsule of the tumor,hepatitis virus infections, albumin, CEA, AFP, CA12-5, blood glucose and serumcalcium content (P＜0.05).3.Protecting factors for overall survival: Based on Kaplan–Meier method we foundthe protecting factors was female, younger than50years old, no smoking history,Child-pugh A grade, normal spleen size, the diameter of tumor smaller than3cm,solitary hepatocellular cacinoma, tumor with capsule, normal serum AFP level, normalserum CEA level, normal serum CA125level and fast blood glucose higher from6.2mmol/L to10mmol/L.Conclusion: Through the research, we find that female, younger than50yearsold, no smoking history, Child-pugh A grade,TNMⅠ, normal spleen size, the diameterof tumor smaller than3cm, solitary hepatocellular cacinoma, tumor with capsule,without hepatitis virus infections,normal serum albumin level, normal serum AFP level,normal serum CEA level, normal serum CA125level, fast blood glucose6.2mmol/L to10mmol/L and normal serum calcium content are revealed as important factors forlong-term survival after hepatectomy. Early diagnosis, early operation, improving liver function, antiviral treatment and improving nutritional status are associated with goodoutcome.