Analysis Of Prognostic Factors After Radical Resection Of Hepatocellular Carcinoma.

Background and Objective: Primary liver cancer(PLC)is one of the most common digestive system tumors in our country,hepatocellular carcinoma,(HCC)is one of the most common type of PLC,85-90% of PLC are HCC,the main therapy is still dominated by surgery,which is the most important means for long-term survival,Surgical procedures include radical liver resection and liver transplantation.The 5-year survival rate of liver cancer after surgery is 40%-50%,and The 5-year survival rate is above 60%.High recurrence rate after liver cancer surgery is the main cause of death.The prognosis of HCC after radical liver resection relies on the clinical staging systems,such as Chinese stage,TNM stage,BCLC stage,OKUDA scoring system,CLIP scoring system,CUPI stage and so on.In some extent,these staging systems can reflect the risk of tumor recurrence,However,only some of them could directly reflect the situation of patients with liver cancer after hepatectomy,and the proportion of various factors was different.Meanwhile,some surgical factors closely related to tumor recurrence were also neglected.This study explored the factors related to the prognosis of patients after radical HCC resection,according to the possible prognosis to take some corresponding therapy measures,making the patients achieve the best therapeutic effect,to maximize the survival time of patients.Method: The clinical data and follow-up results of 112 patients with HCC who underwent radical resection from January 2011 to February 2016 in Yijishan hospital affiliated to Wannan medical college were analyzed as retrospective research objects in this study.Clinical data included patients' gender,age,AST,ALT,GGT,TBIL,DBIL,ALB,PA,AFP,preoperative and postoperative changes in AFP,PLT,Child-Pugh,classification,ascites,liver cirrhosis,hepatitis B surface antigen quantitative,the number of tumor,tumor size,has or does not have an envelope,tumor location,tumor rupture,portal vein tumor thrombosis,microvascular invasion,amount of intraoperative blood loss,blood transfusion,operation procedure(Anatomic /Non-Anatomic),occlusion of hepatic blood inflow or not,tumor differentiation degree,prophylactic transcatheter arterial chemo embolization after radical resection.Kaplan-meier method was used for survival analysis,log-rank test was used for univariate analysis,and Cox model was used for multivariate analysis.Results: The cumulative 1?3 ?5-year survival rates of 112 patients were 84.8%,70.5% and 41.6%,respectively,and the median survival time was 55 months.Univariate analysis suggest the low degree of tumor differentiation,with portal vein tumor thrombosis,occlusion of hepatic blood inflow,anatomic operation procedure,with microvascular invasion,tumor rupture,the more number of tumor,tumor diameter of 5 cm or more,intraoperative bleeding 600 ml or more,no envelope,preoperative and postoperative AFP changes and no TACE treatment was performed postoperativelyare the influence factors of prognosis after the eradicativeresection of HCC;COX model multivariate analysis suggested that tumor diameter 5cm or more,no envelope,tumor rupture,with portal vein tumor thrombosis,with microvascular invasion,low degree of tumor differentiation and preoperative and postoperative APF changes were independent risk factors affecting the prognosis after radical resection of HCC.Conclusion: 1.The cumulative 1?3?5-year survival rates of 112 patients with HCC in our hospital were 84.8%,70.5% and 41.6%,which were similar to the results of domestic studies;2.the low degree of tumor differentiation,with portal vein tumor thrombosis,occlusion of hepatic blood inflow,anatomic operation procedure,with microvascular invasion,tumor rupture,the more number of tumor,tumor diameter of 5 cm or more,intraoperative bleeding 600 ml or more,no envelope,preoperative and postoperative APF changes and no TACE treatment was performed postoperatively are the influence factors of prognosis after the radical resection of HCC;3.tumor diameter 5cm or more,no envelope,tumor rupture,with portal vein tumor thrombosis,with microvascular invasion,low degree of tumor differentiation and preoperative and postoperative APF changes were independent risk factors affecting the prognosis after radical resection of HCC.