Analysis Of Related Factors To Prognosis Of Intermediate Or Advanced Stage Of Hepatocellular Carcinoma After Surgical Resection

Purpose: to explore the overall survival rate and tumor-free survival of intermediate or advanced stage HCC after hepatic surgery as well as screening the risk factors in correlation to survival and recurrence.Method: a retrospective study including 115 patients underwent hepatic resection in the liverish center of First Affiliated Hospital of Fujian Medical University during June 2008 to September 2014 who were intermediate or advanced stage according to BCLC staging, among which 95 were male, and the rest 20 female with the median age of 55. Life table was used to work out the postoperative overall survival rate and tumor-free survival rate of intermediate or advanced stage HCC patients. The effect of various factors have in recurrence and survival was analyzed by Kaplan-Meier method, and the risk factors of intermediate or advanced stage stage HCC patients after surgery were analyzed by COX multivariate analyses.Result:1.After a Median follow-up time of 25(3-70) months, disease-free survival(DFS) of the 115 HCC patients who underwent resection were 49%、41%、34% respectively. Overall survival(OS)of the 115 HCC patients who underwent resection were 70%、60%、40% respectively.2. Kaplan-Meier method was applied to reveal correlations between the tumor-free survival rate and the tumor diameter, existence of satellite lesion, HBVDNA, ALT, AST, GGT, AFP and vascular invasion, Chi-square value of the above K-M analysis were 5.60、5.98、2.83、8.38、5.92、10.19、7.16、3.54(P<0.1)respectively, which were taken into the multivariate analysis to demonstrate that HBVDNA positive and vascular invasion are two independent risk factors to affect the tumor-free survival of middle and advanced HCC patients after surgery with their P 0.005 and 0.028 respectively.3.The same way, Kaplan-Meier method was using to single factor analysis, results indicate that tumor size, presence of satellite, HBVDNA, HBs Ag, ALT, AST, GGT, vascular invasion, time of recurrence of liver cance was significantly correlated with survival.The Chi-square value is 10.28, 8.46, 5.70,4.06, 4.10, 6.49, 5.01, 3.90, 49.95(P<0.05)respectively. These variables included in the multivariate analysis, tumor size, tumor recurrence time is of intermediate or advanced stage hepatocellular carcinoma after hepatectomy in patients with risk factors for survival, respectively p value is 0.04,<0.001Conclusion:HCC patients of middle or advanced stage can still benefit from surgical treatment. And preoperative HBVDNA positive and PVTT are the independent risk factors that influence their tumor-free survival rate, as well as time of recurrence after operation and tumor diameter to the postoperative survival. An important way to ameliorate these patients’ prognosis is early discovery and early treatment.