Long-Term Results of Hepatic Resection Combined with Intraoperative Local Ablation Therapy for Patients with Multinodular Hepatocellular Carcinomas
Long-Term Results of Hepatic Resection Combined with Intraoperative Local Ablation Therapy for Patients with Multinodular Hepatocellular Carcinomas
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DOI：
10.1245/s10434-009-0721-0
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发表时间：
2009-12-01
影响因子：
3.7
通讯作者：
Maehara, Yoshihiko
中科院分区：
文献类型：
--
作者：
Itoh, Shinji;Morita, Kazutoyo;Maehara, Yoshihiko
近年来，局部消融治疗已广泛应用于小肝癌的治疗。本研究评估了肝切除联合术中局部消融治疗多结节型HCC的结果。41例原发性和多结节型HCC患者接受了肝切除联合术中局部消融治疗。所有肿瘤的平均最大直径为3.8 cm（范围2.1-16.0 cm），平均结节数为3.2（范围2-11）。我们使用考克斯比例风险模型评估了生存率和与总生存率相关的预后因素。所有患者均完成了术中局部消融治疗，术后首次CT扫描无残留存活肿瘤。3、5、7年生存率分别为84.3%、61.2%、61.2%。术前去-γ-羧基凝血酶原（DCP）水平> 300 mAU/ml的患者总生存率明显低于DCP水平<300 mAU/ml的患者（P < 0.01），肝切除联合术中局部消融治疗对多结节型肝癌有效。DCP > 300 mAU/ml是长期生存的重要预后因素。
Recently, local ablation therapy has been widely used for treatment of small hepatocellular carcinoma (HCC). The present study assessed the outcome of hepatic resection combined with intraoperative local ablation therapy in patients with multinodular HCCs.Forty-one patients with initial and multinodular HCCs underwent hepatic resection combined with intraoperative local ablation therapy. The mean maximum diameter of all tumors was 3.8 cm (range 2.1-16.0 cm), and the mean number of nodules was 3.2 (range 2-11). We evaluated the survival rates and assessed the prognostic factors associated with overall survival rates using Cox proportional hazard models.Intraoperative local ablation therapy was completed in all patients with no evidence of residual viable tumor on the first postoperative computed tomography (CT) scan. The 3-, 5- and 7-year overall survival rates were 84.3%, 61.2%, and 61.2%, respectively. Patients with preoperative des-gamma carboxyprothrombin (DCP) level > 300 mAU/ml showed significantly worse overall survival than those with DCP level a parts per thousand currency sign300 mAU/ml (P < 0.01).Hepatic resection combined with intraoperative local ablation therapy is effective for multinodular HCCs. DCP > 300 mAU/ml was a significant prognostic factor of long-term overall survival.