Significance of transcatheter chemoembolization combined with surgical resection for hepatocellular carcinomas
Significance of transcatheter chemoembolization combined with surgical resection for hepatocellular carcinomas
复制标题
经导管化疗栓塞联合手术切除治疗肝细胞癌的意义
DOI：
10.1007/bf00647249
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发表时间：
2004
影响因子：
3
通讯作者：
T. Mori
中科院分区：
文献类型：
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作者：
M. Monden;J. Okamura;M. Sakon;M. Gotoh;Kenji Kobayashi;K. Umeshita;Tsuyoshi Yamada;C. Kuroda;M. Sakurai;T. Mori
为提高肝细胞癌术后生存率，对71例肝细胞癌患者行肝动脉化疗栓塞术(TCE)。在本研究中，我们分析了TCE对患者存活率的影响，以及对组织病理学研究中切除的肝脏标本的影响，并与未接受TCE治疗的患者(n=21)进行比较。1年、3年和5年的总生存率(包括住院死亡率)分别为81%、72%和54%。然而，TCE组和非TCE组之间的存活率没有差异。组织病理学研究表明，TCE对主要肿瘤有效，但对肝内转移或门静脉癌栓无效。然而，我们发现在30例肝内转移灶中，有8例肝内转移灶大部分为坏死灶。组织病理学检查证实，这些特殊病例的门静脉血供存在一定的异常。尽管肝内转移或门静脉癌栓的患者预后极差，但除一人外，所有患者在切除后3-48个月内均存活。因此，术前TCE在有效杀死肝内转移瘤时可被认为是一种有用的方法。为了控制病变，门静脉栓塞术可能是一种很有前途的技术。
In order to improve the survival rate after liver resection for hepatocellular carcinoma (HCC), 71 HCC patients were treated with transcatheter chemoembolization (TCE). In the present study, we analyzed the effects of TCE on the patients' survival rates, as well as on the liver specimens resected in a histopathological study, comparing those not treated with TCE (n=21). The overall survival rates, including hospital mortality, for 1 year, 3 years and 5 years were 81%, 72% and 54% respectively. However, no differences were observed in the survival rates between the TCE and the non-TCE groups. A histopathological study demonstrated that TCE was quite effective on the main tumor but not on intrahepatic metastasis or on tumor thrombus in the portal vein. However, we found that most of the intrahepatic metastatic lesions were necrotized in 8 of the 30 cases with these lesions. The histopathological study proved that these particular cases had some abnormalities in the portal blood supply. All but one of them are currently alive 3–48 months after resection, although the prognosis of the patients who had intrahepatic metastasis or a tumor thrombus in the portal vein was extremely poor. Preoperative TCE may, therefore, be thought of as a useful modality when it is effective in killing intrahepatic metastases. To control the lesions, portal vein embolization may be a promising technique in the future.
DOI：
10.1007/978-4-431-68177-9
发表时间：
1992-11
期刊：
Gann monograph on cancer research
影响因子：
--
作者：
S. Arii;T. Tobe
通讯作者：
S. Arii;T. Tobe