Changes and results of surgical strategies for hepatocellular carcinoma: Results of a 15-year study on 452 consecutive patients
Changes and results of surgical strategies for hepatocellular carcinoma: Results of a 15-year study on 452 consecutive patients
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DOI：
10.1007/s005950050299
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发表时间：
1998-01-01
期刊：
影响因子：
--
通讯作者：
Kinoshita, H
中科院分区：
文献类型：
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作者：
Shuto, T;Hirohashi, K;Kinoshita, H
为了为肝细胞癌（HCC）患者确定更好的手术策略，我们对我院15年来接受肝切除术的452例患者进行了回顾性分析。患者分为两组：A组188例1988年前行肝切除术患者，B组264例1989年后行肝切除术患者。对两组进行临床病理比较。A组患儿合并Child's A疾病但无肝硬化的比例较低。A组切除的肿瘤直径较大，大的肝切除和治疗性手术较多。B组出血量少，标本重量轻，住院死亡率较低。两组无瘤生存率相近，但B组生存率明显优于B组。即使是较小的肝切除术，伴随着较低的无切缘手术率，也有助于提高肝切除术的安全性，但并没有提高无瘤生存率。相反，在随访中用于早期发现复发和计划多模式治疗的成像模式的最新进展有助于提高生存率。
In an attempt to define better surgical strategies for patients with hepatocellular carcinoma (HCC), we conducted a retrospective analysis of 452 patients who underwent hepatic resection at our institute during a period of 15 years. The patients were divided into two groups: group A, comprising 188 patients who underwent hepatic resection before 1988, and group B, comprising 264 patients after 1989. These groups were compared clinicopathologically. The percentage of patients with Child's A disease but without cirrhosis, in group A was lower. The diameter of the resected tumor was larger in group A, and major hepatic resections and curative operations were more frequently performed in group A. In group B, there was less blood loss, the specimen weighed less, and the hospital mortality was lower. Although the tumor-free survival rates were similar between the two groups, the survival rate in group B was significantly better. While even minor hepatic resection accompanied by a lower rate of surgical margin-free surgery has contributed to making hepatic resection safer, it has not improved the tumor-free survival rate. Conversely, recent advances in imaging modalities used during follow-up for the early detection of recurrence and for planning multimodality treatment have contributed to increasing the survival rate.