Clinical Analysis Of Primary Hepatocellular Carcinoma Of BCLC-A/B After Surgical Resection

Objective : To discuss the prognosis and risk factors of surgical resection of primary hepatocellular carcinoma in BCLC stage A and stage B and analyzes the related risk factors of the prognosis,in order to provide certain theoretical support for the selection of surgical removal scheme for patients with early period of early period.Methods:Clinical data of 169 patients with HCC who underwent liver resection in the Department of Hepatobiliary Surgery of General Hospital of Ningxia Medical University from January 2012 to December 2015 were retrospectively analyzed.The patients were divided into A group and B group according to the BCLC guidelines,and the prognosis and related risk factors of each stage were analyzed..SPSS25.0 was used for statistical analysis.Kaplan-meier method was used to calculate the median survival time and median disease-free survival time and draw the survival curve.Cox regression method was used to analyze the risk factors of BCLC stage A and BCLC stage B respectively.Results:The median OS of BCLC stage A patients was 70 months,the median DFS was 64 months,the median OS of BCLC stage B patients was 52 months,and the median DFS was 37 months.The 1-year and 3-year rates of OS and DFS were98.9%,64.1%,80.4%,and 48.9% for stage A patients of BCLC,and 92.2%,54.5%,67.5%,and 35.1% for stage B patients of BCLC.COX univariate analysis indicated that the risk factors affecting OS in BCLC stage A patients were tumor diameter and MVI,while the influencing factors affecting DFS were ALT,tumor diameter and MVI.The risk factors influencing OS in BCLC stage B patients were ALT and MVI,while the risk factors influencing DFS were ALT,blood transfusion,ascites and MVI(P<0.05).COX multivariate analysis showed that the independent risk factors for OS and DFS in BCLC stage A were tumor diameter and intravascular cancer embolism.The independent risk factors for OS in stage B of BCLC were MVI and ALT,while the independent risk factors affecting DFS were ALT,MVI and blood transfusion(P<0.1).Conclusion:Hepatectomy for early and middle stage HCC can get a satisfactory prognosis.The independent risk factors for OS and DFS of BCLC-A were tumor diameter and MVI.For patients with BCLC-B,MVI and ALT are independent risk factors for OS,while ALT,MVI and transfusion are independent risk factors for DFS.The 1-year and 3-year overall survival rates after radical resection of HCC in BCLC-B patients are 92.2% and 54.5%,therefore,BCLC-B should not be considered as a surgical contraindication,and appropriate treatment should be developed.