Abstract：
BACKGROUND: The effect of the anatomic location of HCC on the prognosis of patients after hepatectomy is currently unclear.
METHODS: Patients who underwent hepatectomy were retrospectively enrolled and divided into the right tumour resection group (R group) and the left tumour resection group (L group) according to the tumour anatomic location. To avoid bias, 1:2 propensity score matching (PSM) analysis was used. Based on the survival data, disease-free survival (DFS) and overall survival (OS) were evaluated by the Kaplan-Meier method, and long-term survival analysis was performed. Cox proportional hazards regression was used to analyse the risk factors associated with postoperative prognosis.
RESULTS: A total of 700 patients were enrolled in our study. After 1:2 PSM, 354 and 177 patients were enrolled in the R group and the L group, respectively, with comparable baseline characteristics. Survival analysis showed that patients in the L group had a significantly higher recurrence rate than patients in the R group (P = 0.036), but there was no significant difference in the survival rate (P = 0.99). Long-term survival analysis showed that the survival rate of the L group was lower than that of the R group (P < 0.01). Multivariate analysis showed that tumour location in the left liver was an independent risk factor for tumour recurrence (hazard ratio, 1.263; 95% CI, 1.005-1.587) and long-term survival (hazard ratio, 3.232; 95% CI, 1.284-8.134).
CONCLUSIONS: For HCC patients, the recurrence rate and long-term survival rate of left liver tumours were significantly higher than those of right liver tumours, indicating that the anatomical location of the tumour has a significant effect on the survival of HCC patients. Trial registration Chinese Clinical Trial Registry, ChiCTR2100052407. Registered 25 October 2021, http://www.chictr.org.cn/showproj.aspx?proj=135500 .
METHODS: Patients who underwent hepatectomy were retrospectively enrolled and divided into the right tumour resection group (R group) and the left tumour resection group (L group) according to the tumour anatomic location. To avoid bias, 1:2 propensity score matching (PSM) analysis was used. Based on the survival data, disease-free survival (DFS) and overall survival (OS) were evaluated by the Kaplan-Meier method, and long-term survival analysis was performed. Cox proportional hazards regression was used to analyse the risk factors associated with postoperative prognosis.
RESULTS: A total of 700 patients were enrolled in our study. After 1:2 PSM, 354 and 177 patients were enrolled in the R group and the L group, respectively, with comparable baseline characteristics. Survival analysis showed that patients in the L group had a significantly higher recurrence rate than patients in the R group (P = 0.036), but there was no significant difference in the survival rate (P = 0.99). Long-term survival analysis showed that the survival rate of the L group was lower than that of the R group (P < 0.01). Multivariate analysis showed that tumour location in the left liver was an independent risk factor for tumour recurrence (hazard ratio, 1.263; 95% CI, 1.005-1.587) and long-term survival (hazard ratio, 3.232; 95% CI, 1.284-8.134).
CONCLUSIONS: For HCC patients, the recurrence rate and long-term survival rate of left liver tumours were significantly higher than those of right liver tumours, indicating that the anatomical location of the tumour has a significant effect on the survival of HCC patients. Trial registration Chinese Clinical Trial Registry, ChiCTR2100052407. Registered 25 October 2021, http://www.chictr.org.cn/showproj.aspx?proj=135500 .
摘要：
背景：目前尚不清楚HCC的解剖位置对肝切除术后患者预后的影响。
方法：对接受肝切除的患者进行回顾性研究，根据肿瘤解剖部位分为右侧肿瘤切除组（R组）和左侧肿瘤切除组（L组）。为了避免偏见，使用1:2倾向评分匹配(PSM)分析。根据生存数据,通过Kaplan-Meier方法评估无病生存期（DFS）和总生存期（OS），并进行长期生存分析.采用Cox比例风险回归分析与术后预后相关的危险因素。
结果：本研究共纳入700例患者。1:2PSM后，分别为R组和L组354例和177例患者，分别,具有可比的基线特征。生存分析显示,L组患者的复发率明显高于R组患者(P=0.036),生存率差异无统计学意义(P=0.99)。长期生存分析显示,L组生存率低于R组(P<0.01)。多因素分析表明，左肝肿瘤位置是肿瘤复发的独立危险因素(风险比，1.263；95%CI，1.005-1.587）和长期生存率（风险比，3.232；95%CI，1.284-8.134）。
结论：对于HCC患者，左肝肿瘤的复发率和长期生存率明显高于右肝肿瘤，表明肿瘤的解剖位置对HCC患者的生存有显著影响。试验注册中国临床试验注册中心，ChiCTR2100052407。2021年10月25日注册，http://www。chictr.org.cn/showproj.aspx?proj=135500。
方法：对接受肝切除的患者进行回顾性研究，根据肿瘤解剖部位分为右侧肿瘤切除组（R组）和左侧肿瘤切除组（L组）。为了避免偏见，使用1:2倾向评分匹配(PSM)分析。根据生存数据,通过Kaplan-Meier方法评估无病生存期（DFS）和总生存期（OS），并进行长期生存分析.采用Cox比例风险回归分析与术后预后相关的危险因素。
结果：本研究共纳入700例患者。1:2PSM后，分别为R组和L组354例和177例患者，分别,具有可比的基线特征。生存分析显示,L组患者的复发率明显高于R组患者(P=0.036),生存率差异无统计学意义(P=0.99)。长期生存分析显示,L组生存率低于R组(P<0.01)。多因素分析表明，左肝肿瘤位置是肿瘤复发的独立危险因素(风险比，1.263；95%CI，1.005-1.587）和长期生存率（风险比，3.232；95%CI，1.284-8.134）。
结论：对于HCC患者，左肝肿瘤的复发率和长期生存率明显高于右肝肿瘤，表明肿瘤的解剖位置对HCC患者的生存有显著影响。试验注册中国临床试验注册中心，ChiCTR2100052407。2021年10月25日注册，http://www。chictr.org.cn/showproj.aspx?proj=135500。
