Fan J, Yu Y, Wu Z
Liver Cancer Institute of Shanghai Medical University.
Zhonghua Wai Ke Za Zhi. 1997 Dec;35(12):710-2.
To study the therapeutic result of hepatic resection for those hepatocellular carcinoma (HCC) shrunked after transcatheter hepatic arterial chemoembolization (TACE) in the patients with unresectable HCC, authors reported 59 patients with HCC. Among the 59 patients, the maximum diameter of the tumor was 5.6 to 20.0 cm prior to the first TACE, mean 9.43 cm. The patients underwent 1 to 6 times of TACE, mean 2.9 times. The tumor diameters were reduced to 3.29 cm prior to operations. The duration between the last TACE treatment and sequential resection varied from 1 to 7 months, mean 2.53 months. Of the 59 patients, 35 patients' serum alpha-fetoprotein (AFP) levels were elevated. AFP levels returned to normal after TACE treatment in 13 patients. Of the patients, liver segmentectomy, combined liver segmentectomy or partial liver resection was performed in 56 patients, left trilobectomy in 2 and left hemihepatectomy in 1. Tumor necrosis ranged from 40% to 100% pathologically and complete tumor necrosis occurred in 9 patients. Of the 13 patients with AFP levels decreased to normal, 9 still had microscopic living tumor foci. The 1-, 3- and 5- year survival rates were 79.7%, 65% and 56%, respectively. These results indicated that TACE treatment can provide chance of tumor resection for those patients with unresectable HCC and good results can be obtained.
为研究经导管肝动脉化疗栓塞术（TACE）后肿瘤缩小的不可切除肝细胞癌（HCC）患者行肝切除术的治疗效果，作者报告了59例HCC患者。在这59例患者中，首次TACE前肿瘤最大直径为5.6至20.0cm，平均9.43cm。患者接受了1至6次TACE，平均2.9次。手术前肿瘤直径缩小至3.29cm。最后一次TACE治疗与后续肝切除之间的间隔时间为1至7个月，平均2.53个月。59例患者中，35例患者血清甲胎蛋白（AFP）水平升高。13例患者TACE治疗后AFP水平恢复正常。这些患者中，56例行肝段切除术、联合肝段切除术或部分肝切除术，2例行左三叶切除术，1例行左半肝切除术。病理检查肿瘤坏死率为40%至100%，9例出现肿瘤完全坏死。13例AFP水平降至正常的患者中，9例仍有微小活肿瘤灶。1年、3年和5年生存率分别为79.7%、65%和56%。这些结果表明，TACE治疗可为不可切除HCC患者提供肿瘤切除机会，并可获得良好疗效。
