肝移植治疗原发性肝癌88例临床分析

Liver transplantation for the treatment of hepatocellular carcinoma

目的探讨肝移植治疗原发性肝癌的临床意义。方法回顾性分析88例原发性肝癌行原位肝移植患者的临床资料。按照国际抗癌联盟(UICC)制定的肝癌pTNM分期标准,随访比较不同分期患者12个月的肿瘤复发和生存情况。结果术后12个月时,I、II、Ⅲ、Ⅳ期复发率分别为0、4．8％、40．0％和71．3％(P<0．01);I、Ⅱ、Ⅲ、IV期生存率分别为100％、95．2％、71．5％和41．7％(P<0．01)。结论I、Ⅱ期原发性肝癌适合行肝移植治疗,而Ⅳ期肝癌不是肝移植手术适应证。

Objective To retrospectively evaluate the clinical outcomes of liver transplantation for patients with hepatocellular carcinoma （HCC）. Methods The clinical data of 88 consecutive HCC patients who underwent orthotopic liver transplantation between 2002.4 and 2004.7 were retrospectively reviewed. HCC stage of those patients were defined according to the pTNM classification system of UICC. All patients were followed up for more than 12 months after liver transplantation. The recurrence and overall survival rate were evaluated by univariate and muhivariate analysis with SAS software. Results The cumulative 1-year recurrence rate of stage Ⅰ , Ⅱ, Ⅲ and Ⅳ after liver transplantation was 0%, 4.8% , 40.0% and 71.3%, respectively （ P 〈 0. 01 ）. The cumulative 1-year overall survival rate of stage Ⅰ , Ⅱ, Ⅲ and Ⅳ was 100%, 95.2%, 71.5% and 41.7%, respectively （P〈0.01）. Conclusion Liver transplantation may be suitable for stage Ⅰ or Ⅱ hepatocellular cancer patients and improve their prognosis, while it is not suitable for stage Ⅳ HCC patients.