医学
倾向得分匹配
肝细胞癌
肝切除术
内科学
比例危险模型
混淆
队列
胃肠病学
肿瘤科
癌
阶段(地层学)
外科
切除术
古生物学
生物
作者
Shi-Chuan Tang,Kongying Lin,Tingfeng Huang,Kai-Ling Zhang,Jie Kong,Xiaolu He,Cong Luo,Qing-Jing Chen,Pengfei Guo,Weiping Zhou,Yongyi Zeng
出处
期刊:Ejso
[Elsevier]
日期:2023-07-01
卷期号:49 (7): 1234-1241
被引量:1
标识
DOI:10.1016/j.ejso.2023.02.001
摘要
Purpose There is a striking laterality in the site of hepatocellular carcinoma (HCC), with a strong predominance for the right side; however, the impact of primary tumor location on long-term prognosis after hepatectomy of HCC remains unclear. This study aimed to investigate the effect of primary tumor location on long-term oncological prognosis after hepatectomy for HCC. Patients and methods Data of consecutive patients undergoing curative hepatectomy for HCC between 2008 and 2017 were analyzed. Overall survival (OS) and recurrence-free survival (RFS) of left-sided HCC (LS group) and right-sided HCC (RS group) were compared by using propensity score matching (PSM) analysis. COX regression analysis was performed to assess the adjusted effect of tumor location on long-term oncological prognosis. Results Of the 2799 included patients, 707 (25.3%) and 2092 (74.7%) were in the LS and RS groups, respectively. Using PSM analysis, 650 matched pairs of patients were created. In the PSM cohort, median OS (66.0 vs. 72.0 months, P = 0.001) and RFS (28.0 vs. 51.0 months, P < 0.001) were worse among patients in the LS group compared to individuals in the RS group. After further adjustment for other confounders using multivariable COX regression analyses, HCC located on the left side remained independently associated with worse OS and RFS. Conclusion Tumors located on the left side are associated with poorer OS and RFS after hepatectomy for HCC. Careful surgical options selection and frequent follow-up to improve long-term survival may be justified for HCC patients with left-sided primary tumors.
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