关键词: 原发性肝癌, 根治性肿瘤切除术, 预后, 影响因素

Abstract: Objective To investigate the prognosis of patients with primary liver cancer （PLC） after radical tumor resection and analyze the the factors affecting the survival of patients with PLC after radical tumor resection. Method The clinical and pathological data of 301 patients with PLC（194 with tumor diameter >5 cm and 107 with tumor diameter≤5 cm） were retrospectively analyzed in our hospital between January 2008 and January 2012. All the patients underwent radical tumor resection, and followed-up for four years. The COX regression analysis was applied to determine the factors that might affect the survival of the patients. Result There were no significant differences as respect to the clinical parameters,except the tumor diameters,between the two groups（P>0.05）;one month after tumor resection, serum AFP level in patients with tumor diameter >5cm was significantly higher than in those with tumor diameter≤5cm（P<0.05）,while the liver function index in the two group were not significantly different （P>0.05）;the overall survival （OS） in patients with tumor diameter >5cm was （19.2±3.8） m,much shorter than（29.4±4.2）m in patients with tumor diameter ≤5cm,and the disease-free survival （DFS） in patients with tumor diameter >5cm was（12.3±2.7） m,also significantly shorter than （20.9±5.1） m （P<0.05） in patients with tumor diameter ≤5cm;univariate analysis showed than the OS and DFX in patients older than 50 yr,having operation time longer than 240 min,bleeding greater than 500 ml,with underlying liver cirrhosis,with high serum AFP levels, Child-Pugh class B,low serum albumin levels,vascular invasion and tumor diameters decreased obviously（P<005）,and further multivariate analysis demonstrated that tumor diameter,vascular invasion,Child-Pugh class,bleeding and underlying liver cirrhosis were the independent risk factors affecting the patients' OS and DFS （all P<0.05）. Conclusion The radical tumor resection might be the first choice in patients with PLC,and the underlying liver cirrhosis and/or the Child-Pugh class,vascular invasion and tumor diameters might affect the post-operational survival,which the surgeons should take into consideration in making choice of interventional approaches in dealing with patients with PLC.

Key words: Hepatoma, Radical tumor resection, Prognosis, Risk factors