MDT在肝癌肝移植术后复发诊疗中的临床病例实践

Clinical practice of MDT in recurrence of hepatocellular carcinoma following liver transplantation

目的总结1例肝癌肝移植术后反复复发患者的临床诊治过程。方法采用MDT机制,结合患者病情,开展影像科、肿瘤科、放疗科及肝脏外科专家多学科会诊讨论。结果 MDT讨论认为,患者主要诊断为胰体尾占位、肝癌肝移植术后复发,应进一步行全身性肿瘤学评估,若能除外他处转移,限期行胰体尾部切除。遂完善术前准备后,行"胰体尾切除术+脾切除术+肠粘连松解术",切除胰体尾部占位,术后随访期间复查甲胎蛋白(AFP)及腹部CT检查未见肿瘤复发征象。结论 MDT机制可以为临床复杂的肝癌肝移植患者提供个体化的优选治疗方案,使患者获益。

Objective To summarize the specific treatment for a patient diagnosed with recurrence of hepatocellular carcinoma following liver transplantation.Methods Considering the patient＇s condition,multidisciplinary team（MDT） consultation of the specialists in radiology,oncology,radiotherapy,and liver surgery was conducted.Results After the MDT consultation,the patient was advised to receive surgery if the metastasis could be excluded.Surgical removal of the mass located at the body and tail of pancreas＋splenectomy＋enterodialysis was conducted.The alpha fetoprotein（AFP） level and abdominal CT were reviewed and no recurrence was found during the follow up period（by the end of May.2018）.Conclusion The MDT mechanism could provide individualized treatment for patients with complicated hepatocellular carcinoma and benefit those patients.