간암 환자에서 수술 후 예후에 영향을 미치는 인자에 관한 연구

• Published in: Annals of surgical treatment and research p. 8
• Main Authors: 최윤미, 강규철, 안승익, 이건영, 홍기천, 최선근, 허윤석, 김세중, 우제홍, 신석환
• Format: Journal Article
• Language: Korean
• Published: 대한외과학회 01.07.2003
• Subjects: 일반외과학
• ISSN: 2288-6575; 2288-6796

Purpose: Although the resectability of hepatocellular carcinoma has increased due to recent advances in diagnostic methods and surgical techniques, the long-term results are unsatisfactory due to their invasiveness and frequent association with cirrhosis. This study was designed to identify the prognostic factors affecting the long term survival and recurrence of tumors in patients having undergone a hepatic resection for a hepatocellular carcinoma. Methods: Between June 1996 and March 2002, 51 consecutive patients underwent a hepatic resection for a hepatocelluar carcinoma at the Inha University Hospital. The overall cumulative and disease free survival rates for these patients were analysed. Twenty-five clinicopathological factors were evaluated by univariate and multivariate analyse to determine any significant prognostic factors. Results: The cumulative 1, 3 and 5-year survival rates were 84, 70 and 58%, respectively. There were 26 recurrences, and the 1, 3 and 5-year disease free cumulative survival rates were 60, 53 and 31%, respectively. From the univariate analysis, all the factors associated with ascites (P=0.0000), total bilirubin (P=0.0015), albumin (P=0.0271), prothrombin time (P=0.0392), HBe antigen (P=0.0283), Child classification (P=0.0000), celluar differentiation (P=0.0043) were found to correlate with the overall survival. From a Cox regression analysis, the HBe antigen (P=0.019), ascites (P=0.028) were found to be independent prognostic factors of the overall survival. The only factor with an independent effect on disease free survival was the HBe antigen (P=0.037). Conclusion: Because prognosis of HBe antigen-positive patients with ascites is poor, frequent postoperative follow up surveys in these patients are needed. (J Korean Surg Soc 2003;65:42-48) KCI Citation Count: 1