Multidisciplinary treatments for hepatocellular carcinoma with major portal vein tumor thrombus.
Multidisciplinary treatments for hepatocellular carcinoma with major portal vein tumor thrombus.
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DOI：
10.1007/s00595-013-0585-6
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发表时间：
2014-02
期刊：
影响因子：
2.5
通讯作者：
Yamamoto, Masakazu
中科院分区：
文献类型：
--
作者：
Katagiri, Satoshi;Yamamoto, Masakazu
关键词：
近年来，根据背景肝损伤程度、肿瘤直径和与疾病进展相关的其他因素，肝细胞癌（HCC）患者可以选择多种治疗方案。治疗也已转向循证治疗。肝细胞癌合并门静脉癌栓被认为是一种难治性疾病，目前尚未制定治疗政策。手术切除以前被定位为首选治疗方法，但仅切除后的结果却令人失望。目前，由于尚未开发出标准治疗方案，多种跨学科治疗方法将切除与动脉内化疗、放疗、全身化疗和/或免疫治疗相结合，都是在反复试验的基础上使用的。手术结合经动脉化疗栓塞、肝动脉灌注化疗和放疗的临床试验已获得 21.5-56% 的 5 年生存率改善。伴有主要门静脉癌栓的 HCC 手术切除的安全性有所提高，但与切除联合使用的辅助治疗的最佳类型和时机仍有待确定。
In recent years, various treatment options have become available for patients with hepatocellular carcinoma (HCC) according to the degree of background liver damage, tumor diameter and other factors associated with disease progression. Therapy has also shifted toward evidence-based treatment. Policies for the management of HCC with portal vein tumor thrombus, which has been considered an intractable condition, have not been established. Surgical resection was previously positioned as the treatment of choice, but the outcomes after resection alone were found to be disappointing. At present, multiple interdisciplinary treatments, combining resection with intra-arterial chemotherapy, radiotherapy, systemic chemotherapy and/or immunotherapy, are used on a trial-and-error basis since no standard regimens have been developed. Clinical trials of surgery combined with transarterial chemoembolization, hepatic arterial infusion of chemotherapy and radiation have obtained improved 5-year survival rates of 21.5–56 %. The safety of surgical resection in HCC with major portal vein tumor thrombus has improved, but the optimal type(s) and timing of auxiliary therapy to use in combination with resection remain to be defined.
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影响因子：
3.5
作者：
Kaneko, S;Urabe, T;Kobayashi, K
通讯作者：
Kobayashi, K
DOI：
10.1111/j.1440-1746.1990.tb01115.x
发表时间：
1990-11-01
影响因子：
4.1
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EBARA, M;OHTO, M;KONDO, Y
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DOI：
10.1016/j.jamcollsurg.2005.11.012
发表时间：
2006-03-01
影响因子：
5.2
作者：
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通讯作者：
Shimahara, Y
影响因子：
2.5
作者：
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