| 摘要: |
| 目的 采用倾向值匹配法比较解剖性肝切除和非解剖性肝切除两种方法对肝细胞癌预后的影响。方法 回顾性分析2010年1月至2015年12月南昌大学第一附属医院收治的124例接受肝癌切除的肝细胞癌患者的临床资料，其中解剖性肝切除组64例，非解剖性肝切除组60例。利用倾向值匹配的方法均衡组间协变量后，比较两组患者的总体生存率，并用Cox比例风险模型分析影响肝癌预后的危险因素。结果 经倾向值匹配后，解剖性肝切除组（n=29）与非解剖性肝切除组（n=45）患者的中位总体生存时间分别52（44.83~59.17）个月和38（31.45~44.55）个月，组间差异有统计学意义（P=0.005）。Cox回归模型多因素分析显示解剖性肝切除有助于提高肝细胞癌患者的总体生存率（相对危险度为0.54，95%置信区间0.30~0.96，P=0.04）。结论 解剖性肝切除较非解剖性肝切除更能提高肝细胞癌患者的总体生存率。 |
| 关键词: 肝肿瘤 肝细胞癌 存活率分析 倾向值匹配法 肝切除术 |
| DOI：10.16781/j.0258-879x.2016.12.1568 |
| 投稿时间：2016-06-19修订日期：2016-10-13 |
| 基金项目:国家自然科学基金（81450045），江西省卫生和计划生育委员会科研项目（20167194）. |
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| Propensity score-matching method for evaluating the effect of anatomic liver resection and non-anatomic liver resection on prognosis of hepatocellular carcinoma patients |
| LUO Cui-song1\2,LIN Yun1,ZENG Zhi-feng1,JIANG Xing-xing1,SHI Jun2* |
(1. Department of Hepatobiliary and Pancreatic Surgery, the Affiliated Xinyu Hospital of Nanchang University, Xinyu 338000, Jiangxi, China;
2. Department of Hepatobiliary and Pancreatic Surgery, the First Affiliated Hospital of Nanchang University, Nanchang 330000, Jiangxi, China
* Corresponding author) |
| Abstract: |
| Objective To compare the prognoses of hepatocellular carcinoma (HCC) patients who underwent anatomic liver resection (AR) or non-anatomic liver resection (NAR) using propensity score-matching methods. Methods We retrospectively analyzed the clinical data of 124 HCC patients who were treated in the First Affiliated Hospital of Nanchang University between Jan.2010 and Dec.2015. The patients included 64 undergoing AR (AR group), and 60 undergoing NAR (NAR group). Propensity score-matching methods were used to assess the overall survival (OS) of the patients in AR and NAR groups while controlling the potential confounders, and the risk factors of prognosis of HCC patients were analyzed by Cox proportional hazard model. Results In the propensity score-matching cohort, the OS of the patients in AR group (n=29) was significantly longer than that in the NAR group (n=45) after propensity score-matching (52[44.83-59.17] months vs 38[31.45-44.55] months, P=0.005). The Cox proportional hazards model revealed that AR was associated with a superior OS (HR=0.54, 95%CI 0.30-0.96, P=0.04). Conclusion Propensity score-matching method has shown that AR can better improve the OS in HCC patients after liver resection compared with NAR. |
| Key words: liver neoplasms hepatocellular carcinoma survival analysis propensity score matching hepatectomy |
