Fan J, Wu Z, Zhou J
Zhongshan Hospital & Liver Cancer Institute, Shanghai Medical University, Shanghai 200032, China.
Zhonghua Zhong Liu Za Zhi. 2000 May;22(3):247-9.
To compare the therapeutic effect and significance of different treatment methods for hepatocellular carcinoma (HCC) with portal vein tumor thrombi (PVTT).
One hundred and forty-seven HCC patients with tumor thrombi in the main portal vein or the first branch of portal vein were divided into four groups. A, conservative treatment group (n = 18); B, hepatic artery ligation (HAL) and/or hepatic artery infusion (HAI) group (n = 18), periodically received postoperative chemoembolizations; C, excision of HCC with removal of PVTT group (n = 79); D, transcatheter hepatic arterial chemoembolization or portal vein infusion (PVI) or HAI after operation group (n = 32).
The median survival period was 2, 5, 12, and 16 months in group A, B, C, D, respectively. Their 1-, 3- and 5-year survival rates was 5.6%, 0 and 0 in group A; 22.2%, 5.6% and 0 in group B; 53.9%, 26.9% and 16.6% in group C; 82.8%, 48.8% and 41.3% in group D, respectively. The survival rates differed significantly between the 4 groups (P < 0.05).
Resection of cancer with removal of tumor thrombi for HCC with PVTT significantly improves the curative effect and quality of life. Local hepatic chemotherapy or chemoembolization after tumor resection with removal of tumor thrombi may further prolong survival period.
比较不同治疗方法对伴有门静脉癌栓（PVTT）的肝细胞癌（HCC）的治疗效果及意义。
147例主要门静脉或门静脉第一分支有癌栓的HCC患者分为四组。A组为保守治疗组（n = 18）；B组为肝动脉结扎（HAL）和/或肝动脉灌注（HAI）组（n = 18），术后定期接受化疗栓塞；C组为切除HCC并清除PVTT组（n = 79）；D组为术后经导管肝动脉化疗栓塞或门静脉灌注（PVI）或HAI组（n = 32）。
A、B、C、D组的中位生存期分别为2、5、12和16个月。A组1年、3年和5年生存率分别为5.6%、0和0；B组分别为22.2%、5.6%和0；C组分别为53.9%、26.9%和16.6%；D组分别为82.8%、48.8%和41.3%。四组生存率差异有统计学意义（P < 0.05）。
对于伴有PVTT的HCC，切除癌灶并清除癌栓可显著提高疗效和生活质量。切除癌灶并清除癌栓后进行局部肝化疗或化疗栓塞可能进一步延长生存期。
