巨大肝癌切除的“风险”和远期观察(附120例分析)

RISK AND REMOTE OBSERVATION OF GIANT HEPATOCARCINOMA RESECTION(Analysis of 120 cases)

近十多年来原发性肝癌临床诊治研究发展迅速。肝癌切除率和术后生存期大大提高,手术死亡率大大下降,从33.3%降至2.1～7.54% 。尤其是小肝癌的发现率不断提高,术后5年生存率已高达67.9%,手术死亡率则降至1.3～0%。

During the period Jan. 1973-Dec. 1987, 120 patients with primary giant hepatocarcinoma had undergone lobectomy or half-hepatectomy. Among the patients, 104 were male, 16 female, male:female ratio was 6.25:1. The youngest was 9 years old, the oldest was 64, the average age was 41.95 years. The clinical typing and staging were as follows:The simple type patients accounted for 90.83%; cirrhotic type 8.33%; and inflammatory type 0.83%.Stage Ⅰ accounted for 2.5 %, stage Ⅱ 89.16% and stage Ⅱ-Ⅲ 8.33%.Pathology:massive type 81.66%, fusionnodulated type 13.33%, nodular type 5.0%, hepato-cellular carcinoma 0.83%. The hepatic carcinoma greater than 5-10cm in diameter were in 50.0%, 11-19cm in diameter 41.66%, 20-26cm in diameter 8.33%. The weight of resected tumor was less than 200g with 17.5%, 201-500g with 31.66%, 501-1000g with 30.83% and 1001-2000g 17.19%, more than 2000g with 2.5%. Operative resection region:Focus resection was in 20.0%; middle hepatic lobectomy 3.33%; left laternal lobectomy 16.66%; left half-hepatectomy 35.0%; right half-hepatectomy 23.33%; trihepaticlobectomy 1.66%.The operative resection rate was 25.0%; operative death rate was 4.16%; one year survival was 48.21%, three years survival 21.95%, five years survival 20.40%, ten years survival 14.78%(3/21). three patients their survival rate was 14 years and 5-9 months.