肝细胞癌根治性切除术后复发的几个问题

Issues of hepatocellular carcinoma recurrence after curative re-section

对于肝癌（HCC）根治性切除术后复发的防治，目前临床仍有一些问题未达成共识或引起外科医生重视，这影响了复发危险因素和外科手术疗效的评估。为此，本文综述了HCC术后复发的类型，特别是肝内转移和多中心发生（IM和M0）的鉴别，因两者对HCC复发的表现形式和预后起决定性作用。此外，还介绍了小肝癌和根治性切除的定义，解剖性肝切除和复发再切除在预防和治疗术后复发中的价值。了解这些问题有助于临床评估HCC更客观、准确、统一。

Regarding the prevention and treatment of hepatoeellular carcinoma （HCC） recurrence after curative re section, surgeons do not have a clear consensus to evaluate the risk factors of recurrence and effectiveness of surgical re- section. Therefore, postoperative HCC recurrence patterns were reviewed in this article, including differentiating intra- hepatic metastasis （IM） and multicentric occurrence （MO）, which play a key role in manifesting recurrence and patient prognosis. Additionally, the definitions of small HCC and curative resection, and the prophylactic and therapeutic val- ues of anatomic resection and repeated hepatectomy in pa- tients with recurrent HCC were reviewed. Fully understand ing these issues might allow for a more objective, precise, and consistent clinical assessment of HCC.