肝移植术治疗复发性肝细胞癌

LIVER TRANSPLANTATION FOR RECURRENT HEPATOCELLULAR CARCINOMA

目的评价肝移植术治疗复发性肝细胞癌的可行性。方法回顾分析2004年9月至2006年10月本组76例肝细胞癌肝移植病例临床资料,其中11例为切除术后复发再移植(SLT组),65例直接肝移植(PLT组)。比较两组围手术期结果以评价复发性肝癌肝移植的手术安全性。比较两组远期效果及其影响因素。结果SLT组手术耗时和术中输注血制品量高于PLT组(P<0.05),术后并发症和死亡率两组无差别。SLT组和PLT组1年和2年生存率无显著性差异,分别为72%、72%和84%、80%。结论复发性肝癌可作为肝移植适应证,但须有严格的病例选择标准。

Objective To assess the feasibility of liver transplantation （LT） for recurrent hepatocellular carcinoma （HCC） following resection. Methods Between September 2004 and October 2006, among 76 patients with HCC who received LT in our center, 11 patients underwent secondary LT （SLT group） for recurrent HCC following previous liver resection, and the rest were classified into primary LT group （PLT group）. The surgical risks, long-term outcomes and tumor recurring risk factors were evaluated by the comparison of peri-operation data and follow-up results in two groups. Results Compared with PLT group, longer operation time and more transfusion but approximate peri-operative morbidity and mortality were presented in SLT group. 1-year and 2-year survival rates were 72% and 72% in SLT group versus 84% and 80% in PLT group. There was no significant difference. Conclusions Selected patients with recurrent HCC are possibly adapted to liver transplantation.