肝癌切除术中的外科切缘(附544例分析)

The resect margin of hepatectomy for primary hepatocellular carcinoma

目的 了解肝癌切除术中外科切缘对肝癌预后的影响。方法 将大、小肝癌病人根据切缘大小分为四组 ,分析不同切缘肝切除术后的 5年复发率和 5年生存率。结果 切缘有残癌或血管内癌栓者 ,大、小肝癌均有较高的术后复发率而生存率很低。小肝癌切缘≥ 1 0cm及大肝癌切缘≥ 2 0cm者 ,术后 5年复发率明显下降而生存率明显提高。结论 肝癌切除时 ,小肝癌切缘尽可能在 1cm以上 ,大肝癌以 2cm以上为佳。

Objective\ To understand the effect of the resect margin(RM) to hepatectomy for primary hepatocellular carcinoma(PHC).Methods\ In 544 cases,72 cases were small PHC(≤3cm),473 cases were large PHC(>3cm).Four groups were classified according to the distance of RM The 5-year recurrence rate and survival rate after hepatic resection in each group were analyzed.Results\ RM with residue cancer or cancer embolus had a high 5-year recurrencre rate and lower survival rate in both small and large PHC.Small PHC with RM ≥1.0cm and large PHC with RM ≥2.0cm had higher 5-year survival rate and lower recurrence rate.Conclusion\ We recommend RM≥1.0cm for small PHC and RM≥2.0cm for large PHC.