Limited hepatic resection for hepatocellular carcinoma in the caudate lobe
Limited hepatic resection for hepatocellular carcinoma in the caudate lobe
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DOI：
10.1007/s00268-004-7341-4
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发表时间：
2004-07-01
影响因子：
2.6
通讯作者：
Mori, M
中科院分区：
文献类型：
--
作者：
Ikegami, T;Ezaki, T;Mori, M
治疗尾状叶肝细胞癌（HCC）的最合适方法尚未确定。分析了197例因肝癌接受根治性肝切除术的患者。15例患者在尾状叶中患有HCC：3例在Spiegel叶（SP），3例在尾状突（CP），9例在腔静脉旁部分（PC）。SP和CP的肝癌患者接受了部分肝切除术。PC中的HCC采用以下三种方法之一：PC的前入路和部分肝切除术（Ant+PHx-PC）、部分肝切除术或左叶切除术。临床病理学变量，包括潜在的肝脏疾病，平均肿瘤大小，和HCC的病理特征，没有尾状叶手术和其他部分之间的差异。尾状叶肝癌切除术后3年和5年的总生存率分别为88.9%和66.7%;其他节段的相应数字分别为3年和5年的86.1%和68.6%。尾状叶3年和5年无复发生存率分别为51.9%和34.6%，其他节段3年和5年无复发生存率分别为52.1%和32.8%。起源于尾状叶的HCC的临床病理特征与其他节段的HCC无差异。尾状叶有限切除HCC的预后价值与其他节段相似。
The most appropriate approach to treating hepatocellular carcinoma (HCC) in the caudate lobe has not yet been determined. A series of 197 patients who had undergone curative hepatic resection for HCC were analyzed. Fifteen patients had HCC in the caudate lobe: three in the Spiegel lobe (SP), three in the caudate process (CP), and nine in the paracaval portion (PC). Patients with HCCs in the SP and CP underwent partial hepatectomy. HCCs in the PC were approached in one of three ways: anterior approach and partial hepatectomy of the PC (Ant+PHx-PC), partial hepatectomy, or left lobectomy. Clinicopathologic variables, including the underlying liver disease, the mean tumor size, and the pathologic characteristics of HCC, did not differ between surgery of the caudate lobe and that of other segments. The overall survival was 88.9% at 3 years and 66.7% at 5 years after resection of HCC in the caudate lobe; the corresponding figures were 86.1% at 3 years and 68.6% at 5 years for the other segments. The recurrence-free survival rate was 51.9% at 3 years and 34.6% at 5 years for the caudate lobe, and it was 52.1% at 3 years and 32.8% at 5 years for the other segments. Clinicopathologic characteristics of HCCs originating in the caudate lobe were not different from those in the other segments. Limited resection of HCC in the caudate lobe confers a similar prognostic value as in other segments.