NATURAL-HISTORY OF HEPATOCELLULAR-CARCINOMA AND PROGNOSIS IN RELATION TO TREATMENT - STUDY OF 850 PATIENTS
NATURAL-HISTORY OF HEPATOCELLULAR-CARCINOMA AND PROGNOSIS IN RELATION TO TREATMENT - STUDY OF 850 PATIENTS
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DOI：
10.1002/1097-0142(19850815)56:4
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发表时间：
1985-01-01
期刊：
影响因子：
6.2
通讯作者：
OHNISHI, K
中科院分区：
文献类型：
--
作者：
OKUDA, K;OHTSUKI, T;OHNISHI, K
回顾性分析了过去8年中850例肝细胞癌患者的生存率与治疗和疾病分期的关系。根据肿瘤大小、腹水、黄疸和血清白蛋白采用新的分期方案。显然，预后取决于疾病阶段。229例未接受特异性治疗的患者的中位生存期为1.6个月，0.7密苏里州对于III期患者，2.0个月。第二阶段和8.3个月。第一阶段行肝切除术的I期患者（n = 115）的中位生存期为25.6个月。Ⅱ期切除组（n = 42）为12.2个月。在患有小癌症的患者中（≤中位生存期为29.0个月。手术治疗的患者，这代表了一个高度选择的组，生存率优于药物治疗的患者的可比阶段。I期药物治疗患者（n = 124）的中位生存期为9.4个月，II期（n = 290）3.5个月。Ⅲ期（n = 50）1.6个月。药物治疗延长了II期和III期患者的生存期，但不能延长I期患者的生存期。与化疗相比，经导管动脉栓塞术的生存率更高，无论是动脉内推注丝裂霉素C、全身性丝裂霉素C还是口服/直肠替加氟，在II期。在各种化疗方式中，动脉内推注在II期生存率方面优于全身化疗上级。在第三阶段，化疗改善生存相比，没有具体的治疗。死亡原因主要为肝衰竭和消化道出血，可能与合并晚期肝硬化有关。这些结果在生存率方面比过去的报道有了很大的改善，这种差异可能是早期诊断和频繁肝切除的结果。
A total of 850 patients with hepatocellular carcinoma seen during the last 8 yr were analyzed retrospectively for survival in relation to treatment and disease stage. A new staging scheme based on tumor size, ascites, jaundice and serum albumin was used. Clearly, the prognosis depended on disease stage. The median survival of 229 patients who received no specific treatment was 1.6 mo., 0.7 mo. for Stage III patients, 2.0 mo. for Stage II and 8.3 mo. for Stage I. The median survival of Stage I patients who had hepatic resection (n = 115) for 25.6 mo. and Stage II patients with resection (n = 42) was 12.2 mo. In patients who had a small cancer (.ltoreq. 25% of liver area in size), the median survival was 29.0 mo. Survival of the surgically treated patients, which represented a highly selected group, was better than that of medically treated patients of a comparable stage. Median survival of Stage I medically treated patients (n = 124) was 9.4 mo., for Stage II (n = 290) 3.5 mo. and for Stage III (n = 50) 1.6 mo. Medical treatment prolonged survival in Stage II and III patients, but not in Stage I. Transcatheter arterial embolization gave a better survival compared with chemotherapy, whether intra-arterial bolus administration of mitomycin C, systemic mitomycin C, or oral/rectal tegafur, in Stage II. Among various chemotherapeutic modalities, intra-arterial bolus injection was superior to systemic chemotherapy in survival in Stage II. In Stage III, chemotherapy improved survival as compared with no specific treatment. The major causes of death were hepatic failure and gastrointestinal bleeding, probably due to the coexistent advanced cirrhosis. These results in survival are much improved over the past reports and the differences are probably a result of earlier diagnosis and frequent hepatic resections.