关键词: 复发, 生存分析, 乙型肝炎, 小肝癌, 肝硬化, 微波固化, 多因素分析

Abstract:

Objective  To investigate the risk factors of intrahepatic recurrence and survival time after percutaneous microwave coagulation therapy (PMCT) for single small liver cancer patients with hepatitis B virus related cirrhosis. Methods  130 patients′ medical records for 3 years were analyzed retrospectively. The patients with intrahepatic recurrences were divided into the early (≤1 year) and late (2-3 years) recurrence groups, and the patients without recurrence were defined as no recurrence group. The χ2  test and Logistic analysis were used to evaluate the univariate and multivariate analyses associated with intrahepatic recurrence, respectively. Cox proportional hazard model was used to evaluate the univariate and multivariate analyses associated with the survival time. Results  ① 81 patients out of 130 cases were diagnosed with postoperative intrahepatic recurrence (65.85%), in which 50 were early recurrence (39.06%) and 31 were late recurrence (25.20%). ② The irregular boundary of tumor (P=0.010) and distance to the large vascular≤1cm (P<0.001) were related to the early recurrence, and the serum HBV-DNA titer (≥105 copies/mL) was related to the late recurrence (P<0.001). The irregular boundary of tumor (P<0.001), distance to the large vascular ≤1cm (P=0.007) and recurrence time  ≤ 12 months (P=0.008) were related to the survival time. Conclusion  For the single small liver cancer patients with hepatitis B virus related cirrhosis, the irregular boundary of tumor and small diatance to the large vascular are independent risk factors of early recurrence; serum HBV-DNA titer is the risk factor of late recurrence; the irregular boundary of tumor, diatance to the large vascular and recurrence time are the independent risk factors of the survival time.

Key words: Small liver cancer, Microwave coagulation therapy, Multivariate analysis, Hepatitis B, Cirrhosis, Recurrence, Survival analysis