PubMed, EMBASE, the Cochrane Library, and Web of Science were all searched up for relevant studies regarding prognostic factors with SRHCC. RevMan5.3 software and Stata 14.0 software were used for statistical analysis.
A total of nineteen studies with 1876 resected SRHCC patients were finally identified. Pooled results indicated that preoperative AFP (high vs low) (P = 0.003), concurrent liver cirrhosis (yes vs no) (P = 0.02), preoperative liver function (child A vs non-child A) (P = 0.0007), tumor size (large vs small) (P < 0.00001), tumor number (solitary vs multiple) (P = 0.002), satellite foci (yes vs no) (P = 0.0006), micro-vascular invasion (yes vs no) (P < 0.00001), type of hepatectomy (major or minor) (P = 0.04), surgical margin (R + vs R -) (P < 0.00001), and type of hepatectomy (emergency hepatectomy vs staged hepatectomy) (P = 0.005) were prognostic factors for overall survival among post-hepatectomy SRHCC patients.
Apart from some conventional prognostic factors identified in resected patients with SRHCC, numerous prognostic factors have also been unmasked, which might provide clinical reference to stratify patients with different therapeutic regimes.
方法:PubMed,EMBASE,Cochrane图书馆,和WebofScience都在搜索有关SRHCC预后因素的相关研究。采用RevMan5.3软件和Stata14.0软件进行统计分析。
结果:最终确定了总共19项研究,其中1876例切除了SRHCC患者。汇总结果显示术前AFP(高与低)(P=0.003),并发肝硬化(是与否)(P=0.02),术前肝功能(儿童A与非儿童A)(P=0.0007),肿瘤大小(大vs小)(P<0.00001),肿瘤数量(单发vs多发)(P=0.002),卫星焦点(是与否)(P=0.0006),微血管侵犯(是与否)(P<0.00001),肝切除术类型(主要或次要)(P=0.04),手术切缘(R+与R-)(P<0.00001),和肝切除术类型(急诊肝切除术vs分期肝切除术)(P=0.005)是肝切除术后SRHCC患者总体生存的预后因素。
结论:除了在切除的SRHCC患者中确定的一些常规预后因素外,许多预后因素也被揭露,这可能为不同治疗方案的患者分层提供临床参考。