重构肝切除术后的肝衰竭作为HCC中复发后生存的决定因素
Hiroshi Horie1, Satoshi Ogiso1, Tomoaki Yoh1
1Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
Journal of hepato-biliary-pancreatic sciences
|February 12, 2026
概括
肝切除术后肝衰竭 (PHLF) 在肝细胞癌 (HCC) 患者显著恶化长期生存和复发结果. 优先考虑PHLF预防对于改善术后风险和瘤结果至关重要.
科学领域:
- 肝胆道手术是肝胆道的手术.
- 手术瘤学手术瘤学
- 肝癌研究研究 肝癌研究
背景情况:
- 肝切除术后肝衰竭 (PHLF) 通常被视为一种短暂的并发症.
- 它对肝细胞癌 (HCC) 瘤结果的长期影响尚不清楚.
研究的目的:
- 研究PHLF在HCC患者的长期瘤影响.
- 评估PHLF与整体存活率,复发模式和复发后存活率之间的关联.
主要方法:
- 对接受初级肝切除术的HCC患者 (2007-2018) 的分析,随访到2023年.
- 评估整体生存时间 (OS),复发时间 (TTR) 和复发后的生存时间 (SAR).
- 倾向性得分匹配 (PSM) 来控制基线差异.
主要成果:
- PHLF (≥等级B) 发生在14.6%的患者中,与更糟糕的OS和SAR显著相关,但没有TTR.
- 这些关联在PSM之后仍然很重要.
- 在PHLF患者中,复发性HCC显示肝功能较差 (ALBI分数) 并且再次切除率降低.
结论:
- 在HCC中,PHLF危及肝脏储备,限制治愈救援选择,并损害HCC复发后的存活率.
- 预防PHLF对于优化HCC患者的长期瘤结果至关重要.
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