国内外肝移植标准对HBV相关性肝癌患者术后3年生存率影响的初步研究-内科学(消化内科)专业论文.docxVIP

tumor-free survival. Methods: Between October 2004 and February 2008, a total of 117 consecutive patients underwent LT at our Department of Liver Transplantation, and 80 patients (68.38%) were enrolled in our study. Overall and tumor-free survival rates were calculated using the Kaplan-Meier method. All the variables were compared by univariate analysis and those with statistically significance were taken for a forward step-wise multivariate Cox proportional hazards analysis to evaluate the relative risks for overall and tumor-free survival. Results: 1) The 3-year overall and tumor-free survival rates of patients fulfilling Hangzhou criteria and Shanghai fudan criteria were equal to patients fulfilling Milan criteria. Comparing with Milan criteria, Hangzhou criteria and Shanghai fudan criteria expanded the number of patients by 17.65% (6) and 23.53% (8), respectively. And the newly increased patients in these criteria have the same 3-year overall and tumor-free survival rates as Milan criteria. 2) The newly increased patients fulfilling both Hangzhou criteria and Shanghai fudan criteria have better prognosis than those who fulfilling one of the criteria. Tumor recurrence, metastasis and death occurred in those latter ones. 3) The difference of 3-year overall and tumor-free survival rates between living donor liver transplantation and deceased donor liver transplantation did not achieve statistical significance. 4) There’s no significant difference on survival between patients with various child-puge scores. 5) Tumor number, size, distribution, histopathologic grading and macrovascular invasion are independent risk factors of patients’ prognosis. The definite upper limit of single tumor diameter is 9 cm. Conclusion: 1) Domestic criteria can keep the ideal 3-year overall and tumor-free survival rates as Milan criteria, and expand the indication for those who beyond Milan criteria, but with biologically less malignant tumors, and at the same time ensure better prognos