132例复发性肝细胞癌病例的生存分析

目的 研究肝癌复发后的不同治疗方法带来的预后生存的不同。方法 对 2 71例肝癌切除后复发的 132例患者复发情况进行分析 ,同时比较复发后不同治疗方法的结果。结果 6 7%的肿瘤复发位于肝内 ,而且其中近一半是局限性复发 ,这些病例经再次肝切除、经肝动脉插管化疗栓塞或经皮无水酒精注射治疗后 ,5年生存率可达 30 %。同时发现肝移植亦不失为一种好的方法。结论 对于复发性肝细胞肝癌积极的外科治疗可获好的疗效。

右肝切除后7天肝脏再生的全肝与肝脏分段CT容积分析

目的通过术前CT容积估算与右肝切除术后7天CT容积估算对照，评价肝脏的总体再生与分段再生，并研究不同手术指征及保留与不保留肝中静脉（MHV）病人CT容积估算，评估肝脏的再生。材料与方法研究经本地医学伦理委员会与国家医学委员会批准并获取知情同意通知。27例曾行右肝切除的病人术前与术后7天接受了多层螺旋CT扫描。

Recurrence after resection of hepatocellular carcinoma

Objective: To assess the relevant factors of prognosis and the proper treatment of recurrent hepatocellular carcinoma (HCC). Methods: From January 1983 to January 1997, 135 patients with recurrent HCC were analyzed in terms of host condition, tumor characteristics, and surgical procedures. Surgical treatments of these patients were compared. Results: Alpha-fetoprotein (AFP) level>1000 μg/L in the initial operation, tumor size larger than 5 cm in diameter, tumor embolization in the portal veins, 0 surgical margin, and no chemoembolization before the operation were the main factors directly affecting the prognosis in a year after recurrence. Repeat hep- atectomy and liver transplantation were performed to obtain better results. Conclusions: Tumor characteristics and surgical treatment are the main factors affecting the prognosis after the recurrence of HCC. Liver transplantation plays an important role in patients with poor liver function or multi-recurrent sites.