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논문 기본 정보

자료유형
학술저널
저자정보
Dahn Byun (Eulji University College of Medicine) Seul Gi Lee (Eulji University College of Medicine) Hyeyoung Kim (Eulji University College of Medicine) Yunghun You (Eulji University College of Medicine) Jaehag Jung (Eulji University College of Medicine) Je Ho Jang (Eulji University College of Medicine) Moon-Soo Lee (Eulji University College of Medicine) Chang-Nam Kim (Eulji University College of Medicine) Byung Sun Cho (Eulji University College of Medicine) Yoon-Jung Kang (Eulji University College of Medicine)
저널정보
대한외과학회 Annals of Surgical Treatment and Research Annals of Surgical Treatment and Research Vol.103 No.5
발행연도
2022.11
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271 - 279 (9page)

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Purpose: Although protein-induced vitamin K absence or antagonist II (PIVKA-II) has been used as a diagnostic tool for hepatocellular carcinoma (HCC), its prognostic value remains unclear.
Methods: This was a nationwide multicenter study using the database of the Korean Liver Cancer Association. Patients with hepatitis B-related HCC who underwent liver resection as the first treatment after initial diagnosis (2008–2014) were selected randomly. Propensity score matching (1:1) was performed for comparative analysis between those with low and high preoperative PIVKA-II. Univariable and multivariable Cox proportional-hazards regression were used to identify prognostic factors for HCC-specific survival.
Results: Among 6,770 patients, 956 patients were included in this study. After propensity score matching, the 2 groups (n = 245, each) were well balanced. The HCC-specific 5-year survival rate was 80.9% in the low PIVKA-II group and 78.7% in the high PIVKA-II group (P = 0.605). In univariable analysis, high PIVKA-II (>106.0 mAU/mL) was not a significant predictor for worse HCC-specific survival (hazard ratio [HR], 1.183; 95% confidence interval [CI], 0.76–1.85; P = 0.461). In multivariable analysis, hyponatremia of <135 mEq/L (HR, 4.855; 95% CI, 1.67–14.12; P = 0.004), preoperative ascites (HR, 4.072; 95% CI, 1.59–10.43; P = 0.003), microvascular invasion (HR, 3.112; 95% CI, 1.69–5.74; P < 0.001), and largest tumor size of ≥5.0 cm (HR, 2.665; 95% CI, 1.65–4.31; P < 0.001), but not preoperative high PIVKA-II, were independent predictors for worse HCCspecific survival.
Conclusion: Preoperative PIVKA-II is not an independent prognostic factor for HCC-specific survival after liver resection for hepatitis B-related HCC.

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INTRODUCTION
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DISCUSSION
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