Resection of peritoneal metastases from hepatocellular carcinoma.
Resection of peritoneal metastases from hepatocellular carcinoma.
复制标题
肝细胞癌腹膜转移切除术。
作者：
H. Nakayama;T. Takayama;M. Makuuchi;S. Yamasaki;T. Kosuge;K. Shimada;J. Yamamoto
背景/目标
目的：评价肝细胞癌腹膜转移切除在治疗中的作用。
方法论
6例行肝细胞癌腹膜转移瘤切除术。根据原发肝肿瘤的性质、腹膜转移的数目和肝切除至腹膜转移切除的时间来评估患者的生存。
结果
2例患者在接受肝细胞癌切除时有腹膜转移，手术同时进行。在另外4例患者中，在肝切除术后6-34个月(平均18个月)腹膜转移明显；在出现转移时进行了切除。患者在腹膜转移瘤切除后的生存时间为3-31个月。存活1年以上的4例患者有以下特点：1)少量转移结节，2)甲胎蛋白(AFP)值低(平均205 ng/ml)，(3)异时性腹膜转移。
结论
切除肝细胞癌腹膜转移灶可能有助于提高患者的存活率。
BACKGROUND/AIMS
To evaluate whether resection of peritoneal metastases arising from hepatocellular carcinoma (HCC) has a role to play in the management of the disease.
METHODOLOGY
Resections of peritoneal metastases from HCC were performed in 6 patients. The survival of the patients was evaluated in relation to feature of primary liver tumor, number of peritoneal metastases and period between hepatectomy and resection of peritoneal metastases.
RESULTS
Two patients had peritoneal metastases at the time of hepatectomy for HCC, their resection being carried out synchronously. In the other 4 patients, peritoneal metastases became evident between 6 and 34 months (mean: 18) after hepatectomy; resection was performed at the time of presentation of the metastases. Patient survival after resection of the peritoneal metastases ranged from 3-31 months. The 4 patients who survived for more than 1 year had the following features: 1) a small number of metastatic nodules (= or < 4); 2) low alpha-fetoprotein (AFP) values (mean: 205 ng/ml); and, (3) metachronous occurrence of the peritoneal metastases.
CONCLUSIONS
Resection of peritoneal metastases arising from HCC may be of value in improving patient survival.