Systematic review of actual 10-year survival following resection for hepatocellular carcinoma

作者：Gluer Annelise M; Cocco Nicholas; Laurence Jerome M; Johnston Emma S; Hollands Michael J; Pleass Henry C C; Richardson Arthur J; Lam Vincent W T^*

来源：Hepato Pancreato Biliary, 2012, 14(5): 285-290.

DOI：10.1111/j.1477-2574.2012.00446.x

• hepatocellular carcinoma
• primary liver tumour
• hepatectomy
• liver resection
• survival
• systematic review

Background: Hepatic resection is a potentially curative therapy for hepatocellular carcinoma (HCC), but recurrence of disease is very common. Few studies have reported 10-year actual survival rates following hepatic resection; instead, most have used actuarial measures based on the KaplanMeier method. This systematic review aims to document 10-year actual survival rates and to identify factors significant in determining prognosis.
Methods: A comprehensive search was undertaken of MEDLINE and EMBASE. Only studies reporting the absolute number of patients alive at 10 years after first resection for HCC were included; these figures were used to calculate the actual 10-year survival rate. A qualitative review and analysis of the prognostic factors identified in the included studies were performed.
Results: Fourteen studies, all of which were retrospective case series, including data on 4197 patients with HCC were analysed. Ten years following resection, 303 of these patients were alive. The 10-year actual survival rate was 7.2%, whereas the actuarial survival quoted from the same studies was 26.8%. Positive prognostic factors included better hepatic function, a wider surgical margin and the absence of satellite lesions.
Conclusions: The actual long-term survival rate after resection of HCC is significantly inferior to reported actuarial survival rates. The Kaplan-Meier method of actuarial survival analysis tends to overestimate survival outcomes as a result of censorship of data and subgroup analysis.

• 出版日期2012-5