Abstract

Objective To investigate the influencing factors for survival of patients after resection of single hepatocellular carcinoma (HCC) with the diameter>8 cm. Methods Clinical data of 417 patients with single HCC>8 cm who underwent surgical resection in the Eastern Hepatobiliary Surgery Hospital affiliated to the Second Military Medical University between January 2009 and December 2011 were retrospectively analyzed. The informed consents of all patients were obtained and the local ethical committee approval was received. Among them, 374 cases were males and 43 females, aged 17-83 years old with a median age of 54 years old. The postoperative tumor-free survival rate and overall survival rate were analyzed using Kaplan-Meier method. The influencing factors for tumor recurrence and postoperative survival of the patients were analyzed using Cox's proportional hazards regression model. Results The postoperative 1-, 2-, 3-, 5-year tumor-free survival rate was respectively 46.1%, 34.8%, 27.5% and 16.6%, and the overall survival rate was respectively 62.8%, 47.7%, 41.1% and 29.2%. Preoperative HBV-DNA>200 kU/L, preoperative AFP>400 μg/L, liver cirrhosis, microscope satellite lesions and microvascular invasion were the independent risk factors for tumor recurrence (HR=1.421, 1.527, 1.368, 1.481, 1.386; P 200 kU/L, preoperative AFP>400 μg/L, intraoperative blood loss>400 ml, liver cirrhosis, microscope satellite lesions and microvascular invasion were the independent risk factors for postoperative survival (HR=1.389, 1.406, 1.450, 1.521, 1.631, 1.714; P<0.05). Conclusions Preoperative HBV-DNA, preoperative AFP, intraoperative blood loss, liver cirrhosis, microscope satellite lesions and microvascular invasion are the independent influencing factors for the survival of patients after resection of single HCC with the diameter>8 cm. Anti-virus treatment should be actively implemented before surgery, the intraoperative blood loss should be reduced and radical resection should be adopted as possible to reduce the recurrence and improve the postoperative survival of the patients. Key words: Carcinoma, hepatocellular; Hepatectomy; Antiviral therapy; Microvascular invasion; Recurrence; Survival rate; Risk factor

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