Multivariate analysis of factors influencing hepatocellular carcinoma prognosis after hepatectomy

Abstract

Objective To retrospectively study the relationship between several risk factors such as cirrhosis, Child-Pugh classification, tumor size, portal vein tumor thrombus, intraoperative transfusion, hepatic portal occlusion time and the prognosis of hepatic cellular cancer (HCC) patients after hepatic resection. Methods The clinical data of 123 patients who received hepatic resection for HCC at Tongji Hospital between 2007 and 2009 were retrospectively analyzed. Log-Rank test and Cox proportional hazard model were used in the univariate and multivariate analyses of risk factors. Results 1, 2, 3, 5 year recurrence and survival rates were 54.17%, 66.67%, 81.40%, 87.50% and 93.50%, 73.17%, 58.54%, 27.64%, respectively. The mean recurrence time and survival time were 19.5 months and 42.9 months. In univariate analysis, presence of cirrhosis (χ2=11.159, P=0.005), Child-Pugh classification (χ2=7.715, P=0.028), tumor size (≥5cm) (χ2=11.483, P=0.004), presence of portal vein invasion (χ2=22.271, P=0.001) were risk factors affecting HCC recurrence. In multivariate analysis, presence of cirrhosis (χ2=8.993, P=0.003), tumor size (≥5cm) (χ2=4.022, P=0.039), presence of portal vein invasion (χ2=5.023, P=0.027) were independent risk factors affecting HCC recurrence. In univariate analysis, presence of cirrhosis (χ2=7.339, P=0.025), AFP>400 ng/ml (χ2=5.431, P=0.042), Child-Pugh classification (χ2=13.389, P=0.002), tumor size(≥5cm) (χ2=11.342, P=0.003), presence of portal vein invasion (χ2=52.167, P<0.001), hepatic portal occlusion (χ2=5.801, P=0.037), intraoperative blood transfusion (χ2=14.959, P=0.001) were risk factors affecting a shorter overall survival. In multivariate analysis, presence of cirrhosis (χ2=9.133, P=0.003), Child-Pugh classification (χ2=4.799, P=0.028), tumor size (≥5 cm) (χ2=9.101, P=0.004), presence of portal vein invasion (χ2=11.126, P=0.001), hepatic portal occlusion (χ2=3.985, P=0.046) were independent prognostic factors affecting shorter overall survival. Conclusion Cirrhosis, Child-Pugh classification, tumor size (≥5 cm), presence of portal vein invasion, and hepatic portal occlusion were independent prognostic factors for HCC patients after hepatic resection. Key words: Liver neoplasms; Prognosis; Risk factors