Analysis Of 95 Hepatocellular Carcinoma Patients Who Underwent Radical Resection With No Perioperative Blood Transfusion

Objective: Explore the curative effect and prognosis factors of the primary hepatocellular carcinoma patients who underwent radical resection with no perioperative blood transfusion by analyzing their clinical data.Method: 95 patients who have HCC radical resection in the single treatment group in the hepatobiliary surgery department of our hospital during January 2008 to May 2010 are involved in this research. All of their diagnoses are confirmed to be hepatocellular carcinoma by pathology. No patient had perioperative blood transfusion and their clinical data are complete. They were followed up in the method of outpatient service, telephone and petition letter before October 2015. The Kaplan-Meier method was used to calculate the survival rates and to draw the survival curves. Log-rank test and Cox proportional hazard regression model were used to analyze the factors that may influence the prognosis of the patients. The possible factors include: gender, age, liver cirrhosis, preoperative Child-Pugh grade of liver function, preoperative AFP level, the number of tumors, tumor size, the TNM stage of tumor and operation manners. SPSS13.0 was used for the above analysis. In log-rank test, P<0.05 is considered to be statistically significant. In Cox proportional hazard regression model, P<0.05 is the standard of entering the model. Excluding standard is P>0.1.Results: 16 of the 95 patients who have been operated the radical resection with no perioperative blood transfusion were lost to follow. The1-,3-,5-year overall survival rates of the patients are 90.7%, 72.6%, 62.4%, the median survival time is 83.7 months, recurrence-free survival rates were 74.7%, 52.9%, 35.4%. Recurrence-free survival time is 42.2 months. Univariate analysis showed that tumor size, preoperative AFP level, liver cirrhosis, preoperative Child-Pugh grade of liver function are the prognostic factors for the patients, gender, age, the number of tumors, the TNM stage of tumor, operation manners are not the prognostic factors for the patients. Cox multivariate analysis showed that liver cirrhosis, tumor size are the independent prognostic factors for the patients.Conclusion:1. The overall prognosis of the hepatocellular carcinoma patients who underwent radical resection with no perioperative blood transfusion is better than the patients with perioperative blood transfusion. Radical resection is an effective method to treat primary hepatocellular carcinoma.2. For all the 9 factors that may influence the prognosis of the hepatocellular carcinoma patients who underwent radical resection, tumor size, preoperative AFP level, liver cirrhosis, preoperative Child-Pugh grade of liver function are the prognostic factors for the patients. Gender, age, the number of tumors, the TNM stage of tumor, operation manners are not the prognostic factors for the patients.3. Liver cirrhosis, tumor size are the independent prognostic factors for the patients.4. The hepatocellular carcinoma should be diagnosed and treated early. Early radical resection can improve survival rate and lead to better prognosis.5. In the radical resection of the hepatocellular carcinoma, vascular structures should be operated accurately, minimize the side injury as much as possible to avoid blood transfusion,and in this way can we improve the prognosis of the patients.