原发性肝癌482例综合治疗分析

COMPREHENSIVE SURGICAL TREATMENT FOR 482 CASES OF PRIMARY LIVER CANCER

目的 探讨原发性肝癌的合理化治疗。方法 分析我院 1996年 2月至 2 0 0 2年 2月收治的原发性肝癌 4 82例。比较手术切除加全置入式药物灌注装置置入 (TI- DDS) 10 5例 (A组 )、单纯手术切除 4 2例 (B组 )、单纯 TI- DDS38例 (C组 )、经股动脉穿刺肝动脉化疗栓塞 (TACE) 2 97例 (D组 ) 4种方法的疗效。结果 1、2、3年复发率 A、B组分别为 4 7.2 %、5 9.3%、80 .1%和 6 9.5 %、78.4 %、85 .2 %。 1、2、3年生存率 A组为 70 .4 %、5 0 .6 %、2 9.2 % ,B组为 6 2 .6 %、4 7.4 %、2 5 .4 % ,C组为 4 0 .2 %、2 5 .7%、8.3% ,D组为 4 2 .1%、2 7.2 %、10 .1%。A、B组相同项及 C、D组相同项比较 ,A、B组 1、2年复发率有差异 (P<0 .0 5 ) ,余均无差异。结论 肝切除为主的外科综合治疗是肝癌治疗的理想模式 ,影像学检查和手术探查证实无法切除的肝癌分别选择 TACE和 TI- DDS。

Objective To study the reasonable therapy for patients with primary liver carcinoma(PLC).Methods Analysing clinical data of 482 patients with PLC from Feb 1996 to Feb 2002,Compared the effects of 4 ways that included hepatectomy combining totally implantable drug delivey system(TI DDS) in 105 cases(group A),hepatectomy alone in 42 cases(group B),TI DDS alone in 38 cases(group C),and transarterial chemoembolization(TACE) in 297 cases(group D)respectively.Result The 1 ,2,and 3 year recurrent rates of group A and group Bwere 47.2%?59.3%?80.1% and 69.5%?78.4%?85.2% respectively.The 1 ,2 ,and 3 year survival rates of group A,B,C,D were 70.4%?50.6%?29.2%;62.6%?47.4%?25.4%;40.2%?25.7%?8.3% and 42.1%?27.2%?10.1% respectively.The data of group A and group C compared with group B and group D,The 1 ,2 year recurrent rates showed significant differences(X 2 test P <0.05),but no differences in other data.Conclusions For patients with PLC,the hepatectomy oriented comprehensive surgical treatment is an ideal ways.The therapies of patients with can't be resected liver neoplasms verified through imaging or operation are TACE or TI DDS.