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肝切除术治疗结直肠癌肝转移的术前影像学检查 被引量:3
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作者 Timothy L.Franke Richard Kinh Gian Do +2 位作者 william r.jarnagin 陈泓西 宋涛 《中国普通外科杂志》 CAS CSCD 北大核心 2013年第7期828-834,共7页
尽管近来在化疗药上取的了很多进步,但是对于转移性的结直肠癌治疗预后仍然很差,就过去20年而言,肝脏转移灶切除术已作为一种有希望的术式,它能改善结直肠癌肝转移患者的生存率,而且该技术在某些案例中显示出长期的治愈效果。为了扩大... 尽管近来在化疗药上取的了很多进步,但是对于转移性的结直肠癌治疗预后仍然很差,就过去20年而言,肝脏转移灶切除术已作为一种有希望的术式,它能改善结直肠癌肝转移患者的生存率,而且该技术在某些案例中显示出长期的治愈效果。为了扩大转移灶切除术的安全性及功效,合适的术前影像是必须的。CT,MRI,PET方面的进步已经改善了隐蔽病灶的探测而且获得更为清晰解剖形态。而CT,PET,MRI在探查大的肝转移瘤上有相似的敏感性,相对于CT及FDG-PET而言,MRI更擅于探知厘米级以下的肝转移灶,特别是与弥散加权成像(DWI)及肝细胞特异性对比剂结合时效果更显著,CT或许可用来作为一种筛选模式或术前计划制定如剩余肝体积的计算或显露肝动脉灌注分布的动脉解剖情况,而技术进步已经带来了史无前例的高画质与高清晰度的图片,但它仍然无法取代专业的,娴熟的具有丰富经验的影像学专家的角色。 展开更多
关键词 肝切除术 结直肠肿瘤 肿瘤转移 术前影像 综述文献
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Improving actual survival after hepatectomy for intrahepatic cholangiocarcinoma—still a long way to go 被引量:3
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作者 Alexandre Doussot william r.jarnagin +1 位作者 Daniel Azoulay Bruno Heyd 《Hepatobiliary Surgery and Nutrition》 SCIE 2019年第2期161-163,共3页
Complete resection stands as the only potentially curative treatment.Being often late diagnosed,vascular and biliary structures are frequently involved owing to centrally located and/or large lesions at the time of di... Complete resection stands as the only potentially curative treatment.Being often late diagnosed,vascular and biliary structures are frequently involved owing to centrally located and/or large lesions at the time of diagnosis.Consequently,complete resection can require complex hepatectomy often on diseased liver,associated with important risks of mortality and morbidity while benefits in terms of prolonged survival remain often uncertain.To date,only one large series investigating actual long-term survival after curative-intent hepatectomy reported an actual 5-year OS of 13%(1).Indeed,around two thirds of patients experience recurrence,mostly to the liver,and eventually die of disease recurrence(2).These observations suggest first that patient selection for resection might be inadequate.Second,surgery alone seems not able to provide sufficient disease control.For instance,recurrence is frequently observed even with early tumours classified AJCC 8th Edition stage IA disease resulting in an estimated 5-year disease specific survival nearing 60%only. 展开更多
关键词 HEPATECTOMY CURATIVE MORTALITY
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