Nakayama H, Takayama T, Makuuchi M, Yamasaki S, Kosuge T, Shimada K, Yamamoto J
Department of Surgery, National Cancer Center Hospital, Tokyo, Japan.
Hepatogastroenterology. 1999 Mar-Apr;46(26):1049-52.
BACKGROUND/AIMS: To evaluate whether resection of peritoneal metastases arising from hepatocellular carcinoma (HCC) has a role to play in the management of the disease.
Resections of peritoneal metastases from HCC were performed in 6 patients. The survival of the patients was evaluated in relation to feature of primary liver tumor, number of peritoneal metastases and period between hepatectomy and resection of peritoneal metastases.
Two patients had peritoneal metastases at the time of hepatectomy for HCC, their resection being carried out synchronously. In the other 4 patients, peritoneal metastases became evident between 6 and 34 months (mean: 18) after hepatectomy; resection was performed at the time of presentation of the metastases. Patient survival after resection of the peritoneal metastases ranged from 3-31 months. The 4 patients who survived for more than 1 year had the following features: 1) a small number of metastatic nodules (= or < 4); 2) low alpha-fetoprotein (AFP) values (mean: 205 ng/ml); and, (3) metachronous occurrence of the peritoneal metastases.
Resection of peritoneal metastases arising from HCC may be of value in improving patient survival.
背景/目的：评估切除肝细胞癌（HCC）引起的腹膜转移瘤在该疾病治疗中是否具有作用。
对6例HCC腹膜转移瘤患者进行了切除术。根据原发性肝肿瘤特征、腹膜转移瘤数量以及肝切除与腹膜转移瘤切除之间的时间间隔，对患者的生存情况进行了评估。
2例患者在因HCC进行肝切除时已有腹膜转移瘤，同时进行了切除。另外4例患者在肝切除术后6至34个月（平均18个月）出现腹膜转移瘤；在转移瘤出现时进行了切除。腹膜转移瘤切除术后患者的生存时间为3至31个月。存活超过1年的4例患者具有以下特征：1）转移结节数量少（=或<4个）；2）甲胎蛋白（AFP）值低（平均：205 ng/ml）；以及3）腹膜转移瘤为异时性发生。
切除HCC引起的腹膜转移瘤可能对提高患者生存率有价值。
