复发性肝癌再次肝切除72例报告

Rehepatectomy for Treating Recurrent Liver Cancer in Seventy-Two Cases

自１９６０年１月至１９９１年７月，对复发性肝癌施行再次肝切除共７２例，其中２次肝切除者６０例，３次和４次肝切除各为９例和３例。术后存活时间最长的１例已１２年１１月，无肝癌复发。全组１、３、５年术后存活率分别为９８．６％、６９．９％和４９．５％。２次肝切除后１、３、５年术后存活率分别为９０．８％、５３．５％和３６．１％。３次术后１、２、３年存活率分别为１００％、８５．６％和３６．７％。作者认为对术后病人仍应长时间定期检测Ｂ超和ＡＦＰ，特别是在术后两年之内应密切检测有无复发。本组２年内复发率为７２．２％。上述资料表明：有计划、有步骤地进行合理的检查和不失时机地采取手术措施，完全有可能作到复发性肝癌的早期发现、早期诊断、早期定位和早期治疗，获得更为满意的手术疗效。

From January 1960 to July 1991,72 cases underwent reoperation for relapse of liver cancer.Hepatectomy was performed twice in 60cases,three and four times each in 9 and 3 cases respectively.The longest survivor has been 12 years and 11 months and is still in good heslth The 1,3 and 5 year survival rates after the first operation were 98.6%,69.9% and 49.5%respectively,while those after the second operation were 90.8%,53.5% and 36.1% respectively.The 1,2 and 3 year survival rates after the third operation were 100%,85.6% and 36.7% respectively.We recommended that patients after the first operation should be monitored at regular period for a comparatively long time,especially within the postoperative two years as 72.2% patients had tumor recurrence in this period.It can be seen that for the cases of recurrent liver cancer,with the early discovery,diagnosis,timely localization and treatment,better curative results and further improvement of operative results in liver cancer may be obtained only if we can give the patients necessary examination and loss no time for reoperation which will bring satisfactory effects.