转移性肝癌的外科治疗(附208例报告)

Surgical Treatment of Metastatic Hepatic Cancer (Report of 208 Cases )

目的 探讨转移性肝癌手术治疗效果。方法 回顾性分析我院近7 年来收治的208 例转移性肝癌患者资料,根据治疗方式不同,将其分为切除性手术组(116 例)与非切除性手术组(92 例),比较两组的治疗效果。结果 全组手术无死亡,术后1、3、5年生存率分别为56.3%、23.1%和13.0%。切除性手术组患者1、3、5 年总生存率分别为74.1%、39.7%和23.3%,非切除性手术组患者1、3、5年生存率分别为33.7%、2.2%和0,前者的治疗效果明显好于后者(P<0.05)。结论 切除性手术是转移性肝癌有效的治疗方法,能耐受切除者应力争切除治疗。

Objective To explore the effect of surgical treatment of metastatic hepatic cancer. Methods Two hundred and eight patients with metastatic hepatic cancer received surgical treatment in our department during the past seven years, and their information were analyzed retrospectively in this paper. The ages of these patients ranged from 19 years to 82 years, and 133 of them were male, 75 of them were female. Two of them were complicated with hepatocirrhosis, and 5 with polycystic liver. The metastatic cancer originated from gastrointestinal tract in 121 cases (58.2%), and from other parts of the body in 87 cases (41.8%). One hundred and sixteen of the patients received resection treatment (resection group), and 92 of them received non-resecton treatment (non-resection group). The survival rates of the two groups were compared through Chi square test.Results The 1-, 3- and 5-year survival rates for all patients were 56.3%,23.1% and 13.0%, respectively. The 1-, 3- and 5-year survival rates were 74.1 %,39.7% and 23.3% in the resection group respectively and 33.7%, 2.2% and 0 in the non-resection group, respectively. Resection group had a higher survival rate than that of the non-resection group ( P <0.05). The main postoperative complications include pulmonary infection (6 cases), subphrenic infection (2 cases), incisional infection (4 cases).Conclusion Surgical resection is an effective treatment method for the patients with metastatic hepatic cancer. Resection should be conducted as long as they could withstand the surgery.