术前治疗对肝细胞癌患者行肝移植术后生存的影响

Effect of Preoperative Treatment on Survival of Patients with Hepatocellular Carcinoma after Liver Transplantation

摘要: 目的：探讨术前治疗对肝细胞癌(HCC)肝移植患者生存预后的影响。方法：回顾性研究2019年01月至2019年12月31于青岛大学附属医院器官移植中心因肝细胞癌(HCC)行肝移植治疗的58名肝移植患者临床资料。根据术前是否行术前治疗，分对照组(n = 32)，处理组(n = 26)。比较对照组和处理组的临床资料，分析肝癌肝移植患者的预后及危险因素。结果：本研究共纳入58例肝癌肝移植患者，男性病人54例，中位随访时间27.8月，至随访结束，26例患者出现肿瘤复发，复发率为44.8%，17例患者死亡，死亡率为29.3%，研究发现术前治疗可显著提高肝移植术后患者PFS和OS，差异有统计学意义(均为P < 0.05)。单因素及多因素Cox回归分析显示，肿瘤最大直径 > 5 cm，肝被膜侵犯是影响肝癌肝移植患者术后PFS的独立危险因素，术前治疗和肝被膜侵犯是影响肝癌肝移植患者术后OS的独立危险因素，(均为P < 0.05)。结论：肝癌肝移植患者术前治疗可以显著减少术后复发，提高术后的生存时间。

Abstract: Objective: To investigate the effect of preoperative treatment on the survival and prognosis of pa-tients with hepatocellular carcinoma undergoing liver transplantation. Methods: The clinical data of 58 patients with hepatocellular carcinoma (HCC) who underwent liver transplantation in the Organ Transplantation Center of affiliated Hospital of Qingdao University from January 2019 to December 2019 were studied retrospectively. According to the preoperative treatment, the patients were di-vided into control group (n = 32) and treatment group (n = 26). The clinical data of the control group and the treatment group were compared, and the prognosis and risk factors of liver cancer patients undergoing liver transplantation were analyzed. Results: A total of 58 liver cancer patients and 54 male patients were included in this study. The median follow-up period was 27.8 months to the end of follow-up, 26 patients had tumor recurrence, the recurrence rate was 44.8%, 17 patients died, and the mortality rate was 29.3%. It was found that preoperative treatment could significant-ly improve the PFS and OS of patients after liver transplantation, and the difference was statistically significant (all P < 0.05). Univariate and multivariate Cox regression analysis showed that the maximum diameter of tumor > 5 cm and liver capsule invasion were independent risk factors for PFS after liver transplantation. Preoperative treatment and liver capsule invasion were independ-ent risk factors for OS after liver transplantation (all P < 0.05). Conclusions: Preoperative treatment of liver cancer patients undergoing liver transplantation can significantly reduce postoperative re-currence and improve postoperative survival time.