块状型肝癌多途径治疗后再二期手术切除23例疗效分析

Analysis of curative effects of two-stage resection after multimodality treatment of 23 cases of massive liver cancer

目的块状型肝癌多途径治疗后再二期手术切除２３例疗效分析。方法：我所从１９８３年３月至１９９３年１２月共收治原发块状型肝癌５６例，经肝动脉结扎、碘化油化疗药物（Ｍ、Ｄ、Ｆ）混合液灌注、液态硅胶（ＴＨ）栓塞、肝动脉远心端门静脉保留化疗管，术后分期灌注化疗，化疗期间经皮行癌灶无水酒精注射。结果：一期术后半年定期复查瘤体缩小ＰＲ：６０７％（３４／５６）、ＭＲ：２８５％（１６／５６）、ＳＤ：１０７％（６／５６）。复查后依据各个瘤体缩小及体质实况施行二期手术切除２３例、手术切除率为４１１％（２３／５６）。结论：二期手术病例随访结果：１，３，５年生存率为８２６％（１９／２３）、６８３％（１６／２３）、５２３％（９／１７）。（术后满５年者１７例生存９例）。

Aim:To analysis of curative effects of two stage resection after multimodality treatment of 23 massive liver cancer,Methods:From 1983 to 1993,56 massive liver cancer patients were admitted to our hospital and received hepatic artery ligation(HAL),the mixture of lipiodol and chemotherapeutic drug(M.D.F)infusion,TH embolism,portal vein cannulation.After operation,the patients were treated by periodical perfusion chemotherapy.During the interval,anhydrous alcohol was injected percutaneously and the foumula of the dosage was V=4/3π(R+0.3)3(ml).Results:The results of recheck are as follows:PR60.7%(34/56),MR:28.5%(16/56),SD:10.7%(6/56)after half a year of one-stage operation.According to the shrinkage of tumor and the state of patients,23 cases received two-stage resection.The rate of resection is 41.3%(23/56).Conclusion:The 1-,3-,and 5-year survival rate is respectively 82.6%(19/23),68.3%(16/23),52.3%(9/17,9 cases survive among 17cases of 5 years after opertion.)So far 3 cases have lived for 7 years.