使用危险函数来评估肝细胞癌在治愈切除术后复发风险
Wei-Feng Li1, Sin-Hua Moi2,3, Yueh-Wei Liu1
1Liver Transplantation Center and Department of Surgery, Kaohsiung Chang Gung Memorial Hospital, 123 Ta Pei Road, Kaohsiung, Taiwan.
Updates in surgery
|October 31, 2023
概括
预测肝细胞癌 (HCC) 复发是监测的关键. 这项研究发现,基于瘤负担和肝病阶段等风险因素,HCC复发危险峰值有很大差异.
科学领域:
- 肝胆道手术 肝胆道手术
- 在瘤学瘤学.
- 医学统计 医学统计
背景情况:
- 肝细胞癌 (HCC) 在肝切除 (LR) 后复发需要有效的监测策略.
- 了解复发时间和风险对于患者管理至关重要.
研究的目的:
- 通过危险函数分析,分析LR后的HCC患者的复发危险和峰值复发时间过渡.
- 确定各种风险因素如何影响HCC复发模式.
主要方法:
- 在1204名接受LR (2007-2018) 的HCC患者中分析复发风险和复发模式.
- 基于已确定的HCC复发风险因素进行子组分析.
- 利用危险函数来确定峰值复发率和时间.
主要成果:
- 总体而言,HCC复发风险在7.2个月达到峰值 (峰值危险率[pHR]:0.0197).
- 高风险因素 (高瘤负担,AFP ≥400 ng/ml,pT3-4) 在第一年内出现峰值.
- 肝硬化,巴塞罗那诊所肝癌B期,差异化表现出3-5年内多样化的高峰复发.
结论:
- HCC复发的风险和模式是高度可变的,受到个体风险因素的重大影响.
- 危险函数分析为预测复发时间和强度提供了宝贵的见解.
- 基于风险分层的定制监测策略可能会改善LR后的HCC患者的结果.
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