原发性肝癌治疗现状及MDT治疗模式的探讨

Current status for the treatment of primary liver cancer and an exploration of multidisciplinary team model

目的结合中国人民解放军联勤保障部队第九八八医院原发性肝癌(hepatocellular carcinoma,HCC)的治疗现状,探讨HCC多学科团队(multidisciplinary team,MDT)治疗的必要性。方法收集2010年1月至2018年1月收治的HCC患者临床资料,进行回顾性分析。结果HCC治疗以手术切除和经导管动脉栓塞术(transcatheter arterial chemoembo1ization,TACE)为主。行手术切除患者中,存在扩大手术适应证现象;行TACE治疗患者中,部分病灶单发且较小的患者未行手术治疗,再次治疗患者呈指数下降。结论手术切除和TACE治疗,分属外科和内科系统,受知识体系的局限性制约,各专科医生往往只重视本专业内对肿瘤的治疗,对于其他学科的治疗手段缺乏了解,这也是我国HCC治疗现状。为了整合各种治疗方式的优点,实现HCC患者最优化治疗,必须开展有组织的成系统的多学科间的综合治疗。

Objective To discuss the necessity of multidisciplinary team(MDT)model for the treatment of hepatocellular carcinoma(HCC).Methods The clinical data of HCC patients admitted to our hospital from January2010 to January 2018 were collected and retrospectively analyzed.Results The treatment of HCC in our hospital was mainly based on surgical resection and transcatheter arterial chemoembolization(TACE).Among the patients who underwent surgical resection,some of them were operated with extended surgical indications.In the patients who received TACE therapy,some had single and smaller lesions without obtaining surgical treatment and showed an exponential decline in numbers for retreatment.Conclusion Surgical resection and TACE therapy belong to the surgical and internal medical systems separately.Due to a limitation in the knowledge systems,the specialists tend to predominately select and only focus on the HCC treatment with their own specialty,while lacking of knowledge and experience for the treatment methods in other disciplines.This exists in current practice of HCC treatment.In order to integrate the advantages of various treatment regimes and apply optimized treatment on HCC patients,it is necessary to carry out organized and systematic multidisciplinary comprehensive treatment.