多结节性肝癌的治疗研究

Study of Treatment for Multifocal Primary Hepatocellular Carcinoma

目的和方法:总结了145例多结节性肝癌的治疗方法.其中全身化疗55例,肝动脉栓塞化疗29例,多次局部切除33例,局切后并用肝动脉插管化疗28例. 结果:各组AFP转阴率分别为0、38.1%、75.5%、85.0%;各组1、2、35年生存率分别为18.2%、44.8%、51.5%、53.8%;1.9%、18.5%、25.0%、51.9%;0、7.7%、21.9%、48.1%;0、38%、6.9%、19.2%提示,多结节性肝癌手术切除优于化疗,切除后并用肝动脉插管化疗优于单纯局切、非手术治疗者.栓塞化疗优于全身化疗(p均<0.05)

Objective and Methods: 145 cases of multifocal primary hepatocellular carcinoma (MPHC) were stud-ied. Of them 55 cases received systemic chemotherapy, 29 cases had transhepatic arterial embolization and chemotherapy (TAE), 33 cases had local resection and followed in another 28 cases by transhepatic artery chemotherapy . Rasults : Resumption of AFP level to normal was seen in 0,38.1% ,75.5% ,85.0% in the four subgroups. The 1- ,2- ,3- ,5 - year survival rates of these subgroups of patients were 18.2%,44.8%,51.5%, 53.8% ;1 .9% ,18.5%,25.0% ,51.9%;0,7.7%,21.9% ,48.1%;0,3.8% ,6.9% ,19.2% .Conclusions: It suggested that surgical removal of tumor should be more effective than systemic chemotherapy and even more so if it was followed by trasvascular chemotherapy. For unresectable cases, TAE was more effective than systemic chemotherapy(p<0.05).