肿瘤灭活对肝硬化伴肝癌患者肝移植前后生存率的影响

Effect of Tumor Deactivation Before Liver Transplantation Operation on Survival Rate of Patients with Liver Cirrhosis and Hepatic Carcinoma

目的探讨肝硬化伴肝癌肝移植前等待期经过肿瘤灭活时其移植术后生存率的影响。方法对19例肝硬化伴肝癌病人14例术前用动脉化疗栓塞（TACE）或射频消融（RFA）进行肿瘤灭活并与同组5同期未行肿瘤灭活者比较其对术后肿瘤复发及生存率的影响。结果本组19例,随访6～61月，18例获无瘤存活，其中术前行RFA的4例病理见肿瘤坏死；10例TACE中有9例肿瘤有坏死，已平均存活18．1月。未行治疗的6例中1例于术后4个月骨转移，带瘤存活12个月后死亡。结论肝硬化伴肝癌在移植术前等待期用TACE或射频消融行肿瘤灭活，对提高肝癌肝移植远期疗效、提高术后生存率有显著意义。

Objective To investigate the effect of tumor deactivation before liver transplantation （LT） operation on survival rate of patients with liver cirrhosis and hepatic carcinoma （HCC）. Methods 14 in 19 cases with liver cirrhosis and hepatic carcinoma were treated by transcatheter arterial chemoembolization （TACE） or radiofrequency ablation （RFA） to deactivate the tumor before transplantation （ deactivation group）. The difference of tumor recurrence and survival rate between the deactivation group and non-deactivation （control） group were compared. Results 18 in 19 cases were survived without tumor at 6 -61 months following - up. 4 cases treated with RFA and 9 in 10 cases treated with TACE were confirmed tumor necrosis. The 13 cases with preoperative treatment have survived 18.1 months averagely. 1 in the 6 cases without preoperative treatment had bone metastasis 4 months after the operation and survived 12 months with tumor. Conclusions The preoperative tumor deactivation with RFA or TRACE can promote the prognosis of hepatic carcinoma patients and increase the survival rate in the long run.