Chinese experience with hepatectomy for huge hepatocellular carcinoma
Chinese experience with hepatectomy for huge hepatocellular carcinoma
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DOI：
10.1002/bjs.4413
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发表时间：
2004-03-01
影响因子：
9.6
通讯作者：
Zhang, BX
中科院分区：
文献类型：
--
作者：
Chen, XP;Qiu, FZ;Zhang, BX
背景：巨大肝细胞癌（HCC）肝切除术的风险和预后存在争议。方法：回顾性分析525例直径大于10小孔的肝细胞癌切除术的临床资料。通过单因素和多因素分析评估长期生存的预后因素。结果：术后并发症常见（26.8%），5例（0.9%）患者需要开腹手术。30天死亡率为2.7%。术后死亡的主要原因是肝功能衰竭（9例）和出血（4例）。肝切除术后3年、5年和10年的粗生存率分别为34.3%、16.8%和2.9%。结论：影响长期生存的预后因素主要反映肿瘤的生物学行为。对于一般情况较差或肝功能较差的患者，它们只能作为平衡手术风险与切除潜在益处的指南。它们不能单独用于排除有治疗目的的患者的肝切除。肝切除术治疗巨大肝癌安全有效。它应该用于治疗可接受手术风险和可切除肿瘤的患者。
Background: The risks and outcome of hepatic resection for huge hepatocellular carcinoma (HCC) are controversial.Methods: The clinical records of 525 patients who underwent resection of HCC greater than 10 cur in diameter were studied retrospectively. Prognostic factors for long-term survival were evaluated by univariate and multivariate analyses.Results: Postoperative complications were common (26.8 per cent) and five patients (0.9 per cent) required relaparotomy. The 30-day mortality rate was 2.7 per cent. The main causes of postoperative death were liver failure (nine patients) and bleeding (four). The 3-, 5- and 10-year crude survival rates after liver resection were 34.3, 16.8 and 2.9 per cent respectively.Conclusion: Prognostic factors for long-term survival mainly reflected the biological behaviour of the tumour. They can be used only as a guide in balancing the risks of operation against the potential benefits of resection in a patient in poor general condition or with poor liver function. They cannot be used alone to exclude patients from liver resection with curative intent. Liver resection for huge HCC was safe and efficacious. It should be used to treat patients with acceptable surgical risks and resectable tumours.