肝脏移植治疗原发性肝癌20例报告

Orthotopic liver transplantation for hepatocellular carcinoma

目的 探讨原位肝移植技术在治疗原发性肝癌中的地位和疗效。方法 对 1993年 4月至 2 0 0 0年 6月中山医科大学器官移植中心进行的 2 0例原位肝移植术治疗原发性肝癌临床资料进行回顾性研究。其中大肝癌 14例 (直径 >5cm) ,小肝癌 6例 (直径≤ 5cm)。结果 大肝癌组肝移植术后平均存活 6 5个月 ,肝癌复发率为 71% (10 / 14) ;小肝癌组移植术后 1、2年存活率分别为 83 % (5 /6 )和 6 7% (4 / 6 ) ,肝癌复发率为 17% (1/ 6 ) ,两组肝癌复发率的差异有显著意义 (P <0 0 5 )。结论肝移植对肝癌单发 ,直径小于或等于 5cm ,无血管侵犯的小肝癌有良好的疗效 ;对部分病例选择适当的大肝癌患者可获得较好的姑息疗效 ;肝移植围手术期辅助化学药物治疗可能会减少肝癌复发。

Objective [WT5”BZ] To explore the role of liver transplantation in the treatment of hepatocellular carcinoma.[WT5”HZ] Methods [WT5”BZ] Twenty patients received orthotopic liver transplantation for hepatocellular carcinoma between April 1993 and June 2000. Fourteen of these were classified as with “large tumors” with the tumor size greater than 5?cm in drameter and the remaining cases were of “small tumors”. The data on tumor characteristics and patients' outcome were retrospectively analyzed.[WT5”HZ] Results [WT5”BZ] In large tumor group, the patients had an median survival of 6 5 months with tumor recurrence in 71% of the cases, while patients with small tumors had a better survival, 83% at 1 year, and tumor recurrent rate of 17% ( P <0 05).[WT5”HZ] Conclusions [WT5”BZ] The results indicate that small (less than 5?cm), single hepatocellular carcinoma without vascular invasion can be effectively treated by liver transplantation. Liver transplantation may offer palliation for some patients with large HCC. The adjuvant chemotherapy may be useful to improve long term posttransplantation survival for patients with HCC. [WT5”HZ]