Laparoscopic liver resection for hepatocellular carcinoma complicated with significant portal hypertension: A propensity score-matched survival analysis

医学 禁忌症 肝细胞癌 倾向得分匹配 危险系数 肝硬化 腹水 置信区间 门脉高压 内科学 外科 胃肠病学 比例危险模型 总体生存率 存活率 生存分析 替代医学 病理
作者
Zhangyou Guo,Hong Yuan,Bing Tu,Yao Cheng,Xiaomei Wang
出处
期刊:Hepatobiliary & Pancreatic Diseases International [Elsevier BV]
卷期号:22 (4): 358-365 被引量:1
标识
DOI:10.1016/j.hbpd.2022.03.012
摘要

Significant portal hypertension (SPH) is a relative contraindication for patients with resectable hepatocellular carcinoma (HCC). However, increasing evidence indicates that liver resection is feasible for HCC patients with SPH. HCC patients with cirrhosis who underwent laparoscopic liver resection (LLR) in two centers from January 2013 to April 2018 were included. Surgical and survival outcomes were analyzed to explore potential prognostic factors. Propensity score matching (PSM) analysis was performed to minimize bias. A total of 165 patients were divided into two groups based on the presence (SPH, n = 76) or absence (non-SPH, n = 89) of SPH. Patients in the SPH group had longer operative time, more blood loss, and more advanced TNM stage than patients in the non-SPH group (P < 0.05). However, there were no significant differences in the postoperative 90-day mortality rate (n = 0), overall postoperative complications (47.4% vs. 41.6%, P = 0.455), Clavien-Dindo classification (P = 0.347), conversion to open surgery (9.2% vs. 6.7%, P = 0.557), or length of hospitalization (16 vs. 15 days, P = 0.203) between the SPH and non-SPH groups before PSM. Similar results were obtained after PSM. The 1-, 3-, and 5-year overall survival (OS) and recurrence-free survival rates in the SPH group were not significantly different from those in the non-SPH group both before and after PSM (log-rank P > 0.05). After PSM, alpha-fetoprotein (AFP) ≥ 400 μg/L [hazard ratio (HR) = 4.71, 95% confidence interval (CI): 2.69-8.25], ascites (HR = 2.18, 95% CI: 1.30-3.66), American Society of Anesthesiologists (ASA) classification (III vs. II) (HR = 2.13, 95% CI: 1.11-4.07) and tumor diameter > 5 cm (HR = 3.91, 95% CI: 2.02-7.56) independently predicted worse OS. LLR for patients with HCC complicated with SPH appears feasible at the price of increasing operative time and blood loss. AFP, ascites, ASA classification and tumor diameter may predict the prognosis of HCC complicated with SPH after LLR.
最长约 10秒,即可获得该文献文件

科研通智能强力驱动
Strongly Powered by AbleSci AI
更新
PDF的下载单位、IP信息已删除 (2025-6-4)

科研通是完全免费的文献互助平台,具备全网最快的应助速度,最高的求助完成率。 对每一个文献求助,科研通都将尽心尽力,给求助人一个满意的交代。
实时播报
刚刚
1秒前
xiaochuan完成签到,获得积分10
1秒前
尊敬的扬发布了新的文献求助10
1秒前
文静的翠安完成签到,获得积分10
1秒前
猫猫发布了新的文献求助10
1秒前
UU完成签到,获得积分10
1秒前
善良身影发布了新的文献求助10
1秒前
2秒前
DEREK发布了新的文献求助10
2秒前
xmz完成签到,获得积分10
2秒前
李太白云游四海完成签到,获得积分10
2秒前
Zgrey完成签到,获得积分10
2秒前
烂漫的汲完成签到,获得积分10
3秒前
jingyi完成签到,获得积分10
3秒前
石石刘发布了新的文献求助10
3秒前
yang完成签到,获得积分10
3秒前
zhaofw完成签到,获得积分10
4秒前
甜酒发布了新的文献求助10
4秒前
4秒前
wyl发布了新的文献求助10
4秒前
传奇3应助ty采纳,获得10
4秒前
4秒前
willow完成签到,获得积分10
4秒前
5秒前
6秒前
6秒前
7秒前
行走的鱼完成签到,获得积分10
7秒前
Sugar完成签到,获得积分10
7秒前
芈冖完成签到,获得积分10
7秒前
7秒前
苹果半山完成签到 ,获得积分20
8秒前
孙琪发布了新的文献求助10
8秒前
8秒前
十二应助汪汪汪采纳,获得10
8秒前
鲤鱼灵阳完成签到,获得积分10
9秒前
9秒前
tff完成签到 ,获得积分10
9秒前
10秒前
高分求助中
A new approach to the extrapolation of accelerated life test data 1000
Cognitive Neuroscience: The Biology of the Mind 1000
Technical Brochure TB 814: LPIT applications in HV gas insulated switchgear 1000
ACSM’s Guidelines for Exercise Testing and Prescription, 12th edition 500
Nucleophilic substitution in azasydnone-modified dinitroanisoles 500
不知道标题是什么 500
A Preliminary Study on Correlation Between Independent Components of Facial Thermal Images and Subjective Assessment of Chronic Stress 500
热门求助领域 (近24小时)
化学 材料科学 医学 生物 工程类 有机化学 生物化学 物理 内科学 纳米技术 计算机科学 化学工程 复合材料 遗传学 基因 物理化学 催化作用 冶金 细胞生物学 免疫学
热门帖子
关注 科研通微信公众号,转发送积分 3968934
求助须知:如何正确求助?哪些是违规求助? 3513835
关于积分的说明 11170238
捐赠科研通 3249167
什么是DOI,文献DOI怎么找? 1794650
邀请新用户注册赠送积分活动 875278
科研通“疑难数据库(出版商)”最低求助积分说明 804755