肝癌根治术后区域化疗预防复发的价值

The value of postoperative hepatic regional chemotherapy in prevention of recurrence after radical resection for primary liver cancer

目的评价肝脏区域化疗预防肝癌根治术后复发的作用。方法１９９５年１月至１９９７年１２月行肝癌根治性切除１０５例。全部病例均在术后４～６周经肝动脉或联合门静脉行术后肝脏区域化疗，此后每隔２～４个月重复一次。结果随访４～４０（x=２２．７±９．７）个月。１０５例中２例分别于术后１２、１３个月时死于重症肝炎，但无肝癌复发。１０３例存活者１３例复发，其中余肝复发１１例，肺和腹腔转移各１例。术后１、２、３年的累积复发率分别为１％、１５％和１８％。复发距手术时间为１０—２２（Ｘ＝１５．３±２．９）个月。结论术后肝脏区域化疗可明显降低肝癌根治术后复发高峰期的复发率。

Objective To evaluate the efficacy of postoperative hepatic regional chemotherapy in prevention of recurrence after radical resection for primary liver cancer (PLC). Method Between Jan. 1995 and Dec.1997 radical resection was performed in 105 patients with PLC. Hepatic regional chemotherapy was carried out viahepatic artery or combined the latter with portal vein in all patients at 4-6 weeks ther operation, and repeated atregular interval of 2-4 months thereafter. Results All the patients were follwed up for 4-40(x=22. 7±9 .7)months. Two patinets without recurrence died of severe hepatihs at 12 or 13 months,respectively. In the remaining103 patients, recurrence in the remnant liver were found in 11 patients, metastasis to the lung wes found in 1 patient and implantation to the abdominal cavity was found in 1 patient. The 1-, 2-, 3-year recurrence rates 1%, 15% and 18%, respectively. The interval between recurrence and operation varied from 10 to 20 (x=15.2±2.9) months. Conclusion The recurrence rate after radical resection could be significantly decreased by post operative hepatic regional chemotherapy during the peak time of recurrence.