Prognostic Factors Related To Hepatectomy For Hepatitis-associated Large Hepatocellular Carcinoma

Objective:To compare the prognosis of patients with hepatocellular carcinoma associated with hepatocellular carcinoma(HCC)and hepatocellular carcinoma(HCC)with a single diameter of 5 cm or less,and to explore the prognostic factors of patients with solitary hepatocellular carcinoma after hepatectomy.Methods:Retrospective analysis of clinical data of 189 patients with hepatitis B-related single liver cancer who underwent surgical resection of liver cancer from January 2010 to December 2017 in Xinjiang Cancer Hospital,and divided them into small liver cancer group with tumor diameter?5 cm.For example,74 patients with large hepatocellular carcinoma(single-shot,tumor diameter>5cm,no focal foci,clear boundaries between tumor and surrounding liver).Differences between clinical pathological features were described by continuous test using t test,and categorical variables were verified by chi-square test.Survival analysis was performed by Kaplan-Meier method and survival curves were compared.Survival curves were compared using Log-rank test.Logistic regression was used for univariate analysis and Cox regression scale model was used for multivariate analysis to influence the postoperative patients with large liver cancer.Results:In terms of clinicopathological features,microvascular invasion,tumor diameter,alanine aminotransferase(ALT),aspartate aminotransferase(AST),and hepatitis B DNA load were statistically significant(P<0.05).The 1-,3-,and 5-year overall survival rates of patients with small?5 cm diameter of liver cancer were 97.10%,86.40%,and 66.70%.The tumor-free survival rates of 1,3,and 5 years were 86.80%,53.10%,and 33.90%.The 1-,3-,and 5-year overall survival rates of the patients were 89.20%,70.70%,and 40.80%,and the 1-,3-,and 5-year disease-free survival rates were 74.40%,26.00%,and 17.40%.There were significant differences in the overall survival rate and tumor-free survival between the two groups(?~2=12.950,P<0.01)(?~2=6.986,P<0.01).Univariate analysis showed that preoperative cirrhosis(?~2=7.181,P<0.01)and microvascular invasion(?~2=7.541,P<0.01)were risk factors affecting the overall survival time of patients with isolated large liver cancer;multivariate analysis The results suggest that microvascular invasion is an independent risk factor affecting the overall survival time of patients with isolated large liver cancer.Conclusion:The overall prognosis of patients with isolated large liver cancer is worse than that of patients with liver cancer less than or equal to 5 cm in diameter.Positive microvascular invasion is an independent risk factor for survival time after hepatectomy in patients with isolated large liver cancer.