Analyses Of Risk Factors That Influencing The Prognosis Of Primary Liver Cancer After Hepatectomy

AIM: Exploring the prognosis and survival situation of primary liver cancer(PLC), to analyze the prognostic factors of the patients with PLC after hepatectomy, in order to provide the theoretical basis for the clinical treatment and prognosis assessment of the patients with PLC.METHODS: The information of patients with PLC who had been accepted hepatectomy by Anhui Provincial Hospital from January 2007 to August 2008 was analyzed retrospectively. Select some factors that may affect the prognosis of patients with PLC after hepatectomy, such as age of the patients, gender, HBs Ag, hepatitis B virus DNA(HBV-DNA) levels, alpha fetoprotein(AFP), preoperative Child-Pugh Score, alanine aminotransferase(ALT) value, liver cirrhosis, tumor size, number of nodules, with or without integrity fibrous capsule, lymph node metastasis, vascular invasion, intraoperatve blood soss, perioperative blood transfusion, liver door block time, djuvant therapy after hepatectomy and operation method. The method for calculating and analysizing was the software of SPSS 16.0. The survival rates were calculated with the method of Kaplan-Meier. The different factors that related the prognosis of PLC were screened by the Log-rank test and Cox regression.RESULTS: Follow-up to August 31, 2014, 34 cases(11.8%) were lost to follow-up. 252 cases were included, 219 males, 33 females, those age ranged from 21 to 79 years old. The median age was 56 years old. The 1, 3, 5 years cumulative survival rate(SR) of the total group was 90.1%, 70.1% and 26.3%(n=252), the median survival time was 37 months. Univariate analysis showed: Age of the patients, HBs Ag, hepatitis B virus DNA(HBV-DNA) levels, alpha fetoprotein(AFP), preoperative Child-Pugh Score, alanine aminotransferase(ALT) value, liver cirrhosis, tumor size, number of nodules, with or without integrity fibrous capsule, lymph node metastasis, vascular invasion, intraoperatve blood soss, perioperative vascular invasion, adjuvant therapy after hepatectomy and operation method were associated with the prognostic(P<0.05). Multivariable analysis showed: Age of the patients, HBV-DNA levels, AFP, preoperative Child-Pugh Score, ALT value, liver cirrhosis, tumor size, number of nodules, with or without integrity fibrous capsule, lymph node metastasis, vascular invasion, perioperative blood transfusion and operation method were independent prognostic factors(P<0.05).CONCLUSION: 1. The prognostic of the patients with hepatocellular carcinoma after hepatectomy was influenced by many factors, such as the age, preoperative Child-Pugh Score, ALT value, et al. It is important to realize these factors for providing the theoretical basis for the clinical treatment and prognosis assessment of the patients with PLC. 2. A lot of means play a significant role in improving the prognostic of the patients with PLC after hepatectomy, such as early discovery, diagnose and treatment, carefully intraoperative operation, postoperative countercheck and relevant auxiliary treatment positively.