Citation: | WU Li qun, GUO Wei dong, CAO Jing yu, et al. Effects of esophageal varices on the prognosis of patients with hepatocellular carcinoma and hepatic cirrhosis after radical resection[J]. Chinese Journal of Digestive Surgery, 2013, 12(11): 832-837. DOI: 10.3760/cma.j.issn.1673 9752.2013.11.006 |
Objective
To investigate the effects of esophageal varices (EV) on the incidence of complications and prognosis of patients with hepatocellular carcinoma (HCC) and hepatic cirrhosis after radical resection.
Methods
The clinical data of 455 patients with HCC and hepatic cirrhosis who were admitted to the Affiliated Hospital of Qingdao University from January 2001 to December 2010 were retrospectively analyzed. All the patients were divided into the EV group (61 patients) and non EV group (394 patients) according to the results of preoperative imaging examination. The intraoperative condition and the prognosis of the patients in the 2 groups were compared. All the patients were re examined every month within the first 3 months after operation, and then they were re examined every 3 months thereafter. The follow up was ended till December, 2012 or the day of patients′ death. Comparison of the measurement data and rates was done by chi square test; the survival curve was drawn by Kaplan Meier method, and the survival was analyzed using the Log rank test; multivariate analysis was done by Cox proportional hazard regression model.
Results
All the patients received radical hepatectomy. Four patients received hepatectomy+pericardial devascularization, 18 received hepatectomy+splenectomy (3 of them received pericardial devascularization). The ratios of patients with the distance between the resection margin and the tumor< 0.5 cm, splenectomy, volume of intraoperative blood loss≥1000 ml and intraoperative blood transfusion in the EV group were significantly greater than those in the non EV group ( χ 2-136.3 months). There were 218 patients died, including 37 patients in the EV group and 181 in the non EV group. The ratios of patients died of HCC, hepatic diseases or other reasons were 67.57%(25/37), 29.73%(11/37) and 2.70%(1/37) in the EV group, and 86.19% (156/181), 6.63%(12/181) and 7.18%(13/181) in the non EV group, with significant difference between the 2 groups ( χ 2 =12.517, 5.370, 12.711, 4.430, 7.148, 29.616, 47.111, P <0.05). The results of multivariate analysis showed that tumor diameter>5 cm and non solitary tumor were independent risk factors influencing the prognosis of patients with HCC and hepatic cirrhosis after radical resection ( RR=1.639, 2.041, P <0.05) .
Conclusion
The survival time of cirrhotic HCC patients with EV is significantly shorter than those without EV after radical resection, while EV was not the independent risk factor influencing the survival of cirrhotic HCC patients after radical resection.
[1] | Lin Kongying, Lin Jia, Lai Zisen, Lai Yongping, Wang Kui, Chen Jinhong, Zhang Zhibo, Li Jingdong, Tai Sheng, Wang Shifeng, Zheng Siming, Zhang Jianxi, Zheng Lu, Wang Kai, Zhang Jiacheng, Lyu Jiahui, Huang Liming, Zeng Yongyi. Prognostic analysis of postoperative adjuvant therapy for hepatocellular carcinoma after con-version therapy of combined targeted therapy and immunotherapy followed by sequential hepatectomy: a multicenter study[J]. Chinese Journal of Digestive Surgery, 2025, 24(1): 103-112. DOI: 10.3760/cma.j.cn115610-20241210-00550 |
[2] | Liu Zhipeng, Li Zimu, Luo Yule, Zhao Xiaolin, Bai Jie, Jiang Yan, Li Yunfeng, Yu Chao, Huang Fan, Wu Zhaoping, Zhou Jinxue, Yin Dalong, Ding Rui, Guo Wei, Zhu Yi, Chen Wei, Lin Kecan, Yue Ping, Cheng Yao, Dai Haisu, Zhang Dong, Chen Zhiyu. Influence of curative‑intent resection with textbook outcomes on long‑term prognosis of gall-bladder carcinoma: a national multicenter study[J]. Chinese Journal of Digestive Surgery, 2024, 23(7): 926-933. DOI: 10.3760/cma.j.cn115610-20240527-00264 |
[3] | Zhao Ying, Tuo Qingsong, Liao Bing, Liang Yihua, Chen Yanrou, Yin Xiaoyu, Lai Jiaming, Liang Lijian, Chen Dong. Risk factors for textbook outcomes of intrahepatic cholangiocarcinoma after hepatectomy[J]. Chinese Journal of Digestive Surgery, 2022, 21(7): 923-930. DOI: 10.3760/cma.j.cn115610-20220514-00273 |
[4] | Liu Aixiang, Wang Haiqing, Bo Wentao, Feng Xielin, Tian Lang, Zhang Hui, Zhang Mingyi, Hu Yong. Clinical efficacy and prognostic factors analysis of hepatectomy for hepatocellular carcinoma[J]. Chinese Journal of Digestive Surgery, 2019, 18(4): 368-374. DOI: 10.3760/cma.j.issn.1673-9752.2019.04.012 |
[5] | Zou Hao, Wu Liqun.. A propensity score matching analysis of hepatectomy and radiofrequency ablation for patients with solitary hepatocellular carcinoma less than or equal to 5 cm and portal hypertension[J]. Chinese Journal of Digestive Surgery, 2018, 17(10): 1018-1023. DOI: 10.3760/cma.j.issn.1673-9752.2018.10.010 |
[6] | Li Xiangcheng, Wang Ke, Li Changxian, Jiao Chenyu, Wu Xiaofeng, Zhang Hui, Wu Zhengshan, Han Sheng, Ji Guwei, Wang Dong, Zhang Yaodong, Yang Renjie, Yang Xinyang, Wang Xuehao.. Clinical efficacy and prognostic factors analysis of radical hepatectomy of hepatocellular carcinoma in 760 patients[J]. Chinese Journal of Digestive Surgery, 2017, 16(4): 398-404. DOI: 10.3760/cma.j.issn.1673-9752.2017.04.016 |
[7] | Wu Yixi, Liu Jiajia, Liu Junyan, Yu Peiwu, Qian Feng.. Analysis of prognosis and recurrent factors of primary retroperitoneal liposarcoma[J]. Chinese Journal of Digestive Surgery, 2016, 15(12): 1194-1199. DOI: 10.3760/cma.j.issn.1673-9752.2016.12.012 |
[8] | Li Junqiang, Liu Zhong, Hu Xiang. Treatment and prognosis of primary gastric lymphoma[J]. Chinese Journal of Digestive Surgery, 2014, 13(8): 625-628. DOI: 10.3760/cma.j.issn.1673-9752.2014.08.009 |
[9] | WU Li qun, CAO Jing yu, WANG Zu sen, QIU Fa bo, GUO Wei dong, ZHANG Bin, ZHANG Shun. Prognosis of primary liver cancer with different pathological types after hepatectomy: a report of 567 cases[J]. Chinese Journal of Digestive Surgery, 2012, 11(6): 561-565. DOI: 10.3760/cma.j.issn.1673-9752.2012.06.018 |
[10] | DONG Na na, DUAN Xiao feng, ZHANG Ti, LI Hui kai, ZHOU Hong yuan, NIU Guangcai, SHEN Changming, LI Qiang. Analysis of treatment and prognosis of primary gallbladder cancer[J]. Chinese Journal of Digestive Surgery, 2012, 11(3): 267-270. DOI: 10.3760/cma.j.issn.1673-9752.2012.03.020 |