原发性肝癌268例综合治疗分析

The comprehensive treatment for hepatocellular carcinoma(a report of 268 cases).

目的 为了进一步探讨和总结肝癌综合治疗的方法和疗效。方法 回顾性分析了近 5年来收治的原发性肝癌 2 6 8例的治疗方法和初步疗效。其中包括男 2 2 9例 ,女 39例 ,平均年龄 41岁 ,肿瘤多属中晚期。手术 137例 ,非手术 131例 ,手术中包括规则与不规则切除、一期切除、二步切除和复发再切除及人体原位肝移植。非手术治疗包括TACE、PEI、DDS、冷冻、中医中药、生物治疗、全身化疗等方法。结果 手术率为 5 1%(137/ 2 6 8) ,全组手术切除率为 85 % (116 / 137) ,手术死亡率 2 2 % (3/ 137) ,术后并发症发生率 2 0 9% ,6个月内复发和转移率为 2 0 7% (32 / 115 )。 1例大肝癌肝移植后已存活 2个月 ,AFP降为正常 ,无复发。结论 以手术为主的综合治疗仍是目前原发性肝癌的理想治疗模式 ,积极的治疗值得提倡 ,全身化疗不容忽视 ,原位肝移植应进一步探讨。

Objective To explore and sum up the comprehensive treatment modalities and outcome of hepatocellular carcinoma.Methods 268 patients with primary hepatocellular carcinoma were analyzed retrospectively from Jan 1994 to Jun 1999.The patients consisted of male 229, female 39, average age 41 years, operation 137, nonoperation 131.Most of them were TNM Ⅱ～Ⅲ stage.First and sequential resection, recurrent lesions resection again, liver transplant, TACE, PEI, DDS, Cryosurgery, system chemotherapy, Chinese medicine, et al. were contents of comprehensive treatment modalities .Results The operation ratio, resection ratio, recurrent ratio within 6 months, morbidity and motality were 51%(137/268), 85%(116/137),20 7%(32/115),20 9% and 2 2%(3/137) respectively.One patient who received liver transplantation has been surviving for more than two months, AFP level decreased to normal postoperatively. Conclusions Liver resection combined with other nonoperation modalities are ideal ways to treat hepatocellular carcinoma at the present. System chemotherapy must not be ignored.It is necessary to study further for liver transplantation to HCC.