Comparison of hepatic resection and hepatic transplantation in the treatment of hepatocellular carcinoma among cirrhotic patients
Comparison of hepatic resection and hepatic transplantation in the treatment of hepatocellular carcinoma among cirrhotic patients
复制标题
肝硬化患者肝切除与肝移植治疗肝癌的比较
DOI：
10.1007/bf02557525
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发表时间：
2002
影响因子：
3.7
通讯作者：
A. Livingstone
中科院分区：
文献类型：
--
作者：
M. Shabahang;D. Franceschi;N. Yamashiki;R. Reddy;P. Pappas;Kuky Aviles;S. Flores;A. Chaparro;J. Levi;D. Sleeman;A. Tzakis;Tomoaki Kato;D. Levi;A. Livingstone
背景与肝切除(HR)相比，肝移植(HT)在治疗肝硬变患者的肝细胞癌(HCC)方面的优势仍存在争议。方法对1997-2000年间因肝细胞癌而行HR或HT治疗的所有肝硬变患者的病历进行分析。HR组的所有患者都患有Child‘s A病，而HT组包括23%的Child’s A和77%的Child‘s B和C患者。虽然所有的高血压患者至少在重症监护病房呆了三个晚上，但41%的HR组从未需要重症监护。两组围手术期死亡率均为7%。病理分析显示，HR组有43%的人患有T1/T2病，而HT组的这一比例为75%。经36个月的随访，两组患者的总生存率(57%比66%)和无瘤生存率(36%比66%)差异无统计学意义。结论以总体生存率和无瘤生存率为主要指标，两组患者的HR和HT值具有可比性。在这组患者中，心率不仅是一种有效的治疗形式，而且与更快的康复有关。
BackgroundThe benefits of hepatic transplantation (HT) compared with hepatic resection (HR) in treating hepatocellular carcinoma (HCC) in patients with cirrhosis are controversial. The aim of this study was to compare the results of these therapeutic options.MethodsThe charts of all patients with cirrhosis who underwent HR or HT for HCC between 1997 and 2000 were analyzed.ResultsThe cohort included 44 patients who underwent HR compared with 65 with HT. All patients in the HR group had Child's A disease, in contrast to the HT group, which included 23% Child's A and 77% Child's B and C patients. Whereas all HT patients spent at least three nights in the intensive care unit, 41% of the HR group never required critical care. Perioperative mortality was 7% in both groups. Pathologic analysis revealed T1/T2 disease in 43% of the HR group compared with 75% of the HT group. After 36 months of follow-up, there was no significant difference in overall survival (57% vs. 66%) or disease-free survival (36% vs. 66%) between the two groups.ConclusionsWith overall survival and disease-free survival as the main outcomes, the results of HR versus HT are comparable in Child's A patients with HCC. In this patient subset, HR not only is an effective form of therapy, but is also associated with quicker recovery.
影响因子：
5.2
作者：
Iwatsuki, S;Dvorchik, I;Starzl, TE
通讯作者：
Starzl, TE
影响因子：
9
作者：
Fong, YM;Sun, RL;Blumgart, LH
通讯作者：
Blumgart, LH
肝癌应该进行肝切除还是肝移植治疗？
影响因子：
6.2
作者：
Yamamoto,J;Iwatsuki,S;Kosuge,T;Dvorchik,I;Shimada,K;Marsh,JW;Yamasaki,S;Starzl,TE
通讯作者：
Starzl,TE