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分析手术前的时间和肝细胞癌瘤负担得分之间的相互作用

Miho Akabane¹, Jun Kawashima¹, Selamawit Woldesenbet¹

¹Department of Surgery, The Ohio State University Wexner Medical Center and The James Comprehensive Cancer Center, Columbus, OH, United States.

Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract

|November 29, 2024

概括

为肝细胞癌 (HCC) 加快手术对于瘤负担得分 (TBS) 较低的患者至关重要. 延迟手术 (>60天) 对这些患者的存活率有显著影响,但对于高TBS患者而言没有影响.

科学领域:

肝胆道手术肝胆道手术
手术瘤学手术瘤学
肝细胞癌研究肝细胞癌研究

背景情况:

时间到手术 (TTS) 对肝细胞癌 (HCC) 治疗意图肝切除术后的结果的影响正在争论中.
在HCC患者中,瘤负担得分 (TBS) 和TTS之间的相互作用尚未得到充分理解.
本研究评估了TBS和TTS对长期HCC结果的综合影响.

研究的目的:

为了研究时间到手术 (TTS) 对整体存活率 (OS) 和癌症特异性存活率在接受肝切除术的HCC患者的影响.
为了确定瘤负担得分 (TBS) 和TTS之间关于长期结果的相互作用.
确定TTS可能是生存的关键因素的患者子组.

主要方法:

从一个多机构数据库分析了2000年至2022年间接受治疗意图肝切除术的910名HCC患者.
患者被分为短TTS (≤60天) 和长TTS (>60天) 组.
总生存率 (OS) 和癌症特异性生存率使用多变量分析进行评估,包括TBS和TTS之间的相互作用分析.

主要成果:

总体而言,短TTS (70.0%) 和长TTS (63.1%) 组之间的5年OS没有显著差异 (P=.05).
多变量分析确定了TBS,日志α-fetoprotein和专-bilirubin得分作为OS的显著预测因素,而TTS不是.
观察到一种相互作用效应:长时间的TTS与低TBS (≤5) 的患者的生存状况恶化有关,但在高TBS患者中并非如此. 在低TBS患者中,长TTS是OS的风险因素 (HR,3.12;P <.001).

结论:

在管理HCC时,应考虑与患者和瘤特异性因素一起进行手术的时间 (TTS).
加快TTS可能对患有HCC和低瘤负担得分 (TBS) 的患者特别有益.
TTS的预后意义取决于瘤负担,强调了个性化的手术时间的方法.

关键词:

这是一种肝切除术 (hepatectomy).肝细胞癌是肝细胞癌.总体生存率总体生存率到了手术的时间.瘤负担得分 (Tumor Burden Score) 是一个指标.

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