The Influencing Factors Of Liver Regeneration After Hepatectomy For Hepatocellular Carcinoma And The Relationship Between Liver Regeneration And Prognosis

Objective: To explore the influencing factors of liver regeneration after hepatectomy for hepatocellular carcinoma and the relationship between liver regeneration level and prognosis.This study is based on three-dimensional reconstruction technology,and uses the liver CT interpretation and analysis system(our hospital’s original research Hisense3 D medical simulation surgery system)to perform three-dimensional liver reconstruction on CT image data,in order to achieve accurate quantification of liver regeneration level in patients after hepatectomy,and to conduct follow-up surveys on postoperative patients,Data integration to explore the influencing factors of liver regeneration after hepatectomy and the relationship between liver regeneration level and prognosis.Method: A total of 97 patients who underwent anatomical hepatectomy for hepatocellular carcinoma from January 2015 to October 2021 in the Department of Hepatobiliary Surgery of our hospital were selected and included in the study,with CT scans at 2 days and 1 month after surgery and complete clinical follow-up data.For these97 patients,we utilized patient CT examination information and used the Hisense CAS system to perform three-dimensional liver reconstruction.We obtained residual liver volume and liver volume at 1 month after liver resection,and calculated the regeneration rate of residual liver volume at 1 month after surgery to quantify the level of liver regeneration in patients after liver surgery.Next,statistical analysis was performed on the data,using the median liver regeneration rate after surgery as the cutoff value.97 patients were divided into two groups: the high regeneration group and the low regeneration group.Incorporate predictive factors that may affect liver regeneration after liver resection for hepatocellular carcinoma during the perioperative period into statistical analysis,explore significant factors that may affect liver regeneration after liver resection for hepatocellular carcinoma.At the same time,collect patients’ tumor free survival time,overall survival time,and survival status,and conduct statistical survival time series analysis to explore the relationship between liver regeneration level and prognosis after liver resection.Result: 1.A total of 97 patients with hepatocellular carcinoma undergoing hepatectomy were included,including 31 patients with left hemihepatectomy and 66 patients with right hemihepatectomy.The median liver regeneration rate in all patients after surgery was 17.6%.The median postoperative liver regeneration rate in the right hemihepatectomy group was 20.29%;The median postoperative liver regeneration rate in the left hemihepatectomy group was 12.2%.2.Univariate analysis showed that age(P<0.05),gender(P<0.05),drinking history(P<0.05),degree of cirrhosis(P<0.05),and standard residual liver volume(P<0.001)showed statistical differences between the high regeneration group and the low regeneration group(P<0.05).3.Multivariate logistic regression analysis showed that the degree of cirrhosis(P<0.05)and standard residual liver volume(P<0.001)were the main risk factors affecting liver regeneration after hepatocellular carcinoma resection.4.The median tumor free survival period of the high regeneration group was 14 months,with a 95% CI of 8.787-15.213.The median tumor free survival period of the low regeneration group was 23 months,with a 95% CI of 18.598-27.402.The difference in tumor free survival between the two groups was statistically significant(P<0.05).Conclusion: Before hepatectomy for hepatocellular carcinoma,the degree of cirrhosis and standard residual liver volume of the patient should be fully considered.The article proves that it is two independent risk factors affecting postoperative liver regeneration.Therefore,for standard residual liver volume,we can use three-dimensional reconstruction technology to simulate liver resection to obtain RLV before surgery,and evaluate our surgical method and surgical risk based on the degree of liver cirrhosis in patients.In terms of patient prognosis,we should pay full attention to patients in the high regeneration group after surgery,by exploring the relationship between regeneration level and recurrence after hepatectomy,the prognostic evaluation value of imaging for primary liver cancer can be improved,which is of great significance for guiding preoperative planning of surgical resection range and targeted drug selection timing and other comprehensive treatment plans.