原发性巨大肝癌的综合治疗186例分析

Comprehensive therapy for giant primary liver cancer:a report of 186 cases

目的探讨巨大肝癌综合治疗的方法和疗效,以进一步提高肝癌的治疗效果。方法回顾性分析近5年我院收治的186例原发性巨大肝癌的治疗情况,其中125例行手术治疗,包括19例先行经皮股动脉穿刺肝动脉化疗(TACE)后再行Ⅱ期肿瘤切除,32例单纯肿瘤切除治疗,69例肿瘤切除后行周围静脉或腹腔内化疗等综合治疗,手术不能切除5例;其中非手术治疗61例,包括43例行TACE治疗;18例行周围静脉或腹腔内化疗。结果手术并发症发生率11%,术后1个月内死亡1例,单纯手术组1、2、3年的生存率分别为78.1%,62.5%,46.5%,手术联合综合治疗组1、23、年的生存率分别为87.5%,76.1%,60.2%。结论巨大肝癌以手术切除为主的综合治疗方法可提高患者的远期生存率。

Objective To investgate the effect of surgical treatment and comprehensive therapy for giant primary liver cancer. Methods One hundred and eighty-six cases of gaint primary liver cancer received surgical treatment and comprehensive therapy in recent 5 years ware analyzed retrospectively. Among them, 120 cases were treated with various modes of hepatectomy; The other 61 nonresectable cases were treated with various combinations of therapy, such as TACE, venus and intraperitoneal chemotherapy. Results The postoperative complications was 11%. For the resection group, the 1-, 2- and 3 year survival rates were 78.1%, 62.5 % and 46.5 %, respectively. For the resection and intraperitoneal chemotherapy group, the 1-, 2- and 3 year survival rates were 87.5% ,76.1% and 60.2% ,respectively. Conclusion Surgery-predominant comprehensive therapy is effective modiality for resectable PLC. Postoperative individualized comprehensive treatment can prevent tumor recurrence and improve postoperative effect.