Marín-Hargreaves Guillermo, Azoulay Daniel, Bismuth Henri
Centre Hépato-Biliaire, Hôpital Paul Brousse, Villejuif et Université Paris-Sud, 12 avenue Paul Vaillant Couturier, 94800 Villejuif, Paris, France.
Crit Rev Oncol Hematol. 2003 Jul;47(1):13-27. doi: 10.1016/s1040-8428(02)00213-5.
Hepatocellular carcinoma (HCC) is a tumour of increasing incidence that usually arises in cirrhotic liver. Untreated, the prognosis is grim and the only curative treatment is surgical resection. The practical application of segmental surgery to the liver together with the use of ultrasound and other imaging techniques, patient selection criteria and improvements in perioperative technique and postoperative care have contributed to better results in hepatic surgery. Today, less than 10% mortality for resection of cirrhotic livers, with up to 50% 5-year survival rates are to be expected. However, the limits of resection for cure: intrahepatic recurrence makes stringent follow-up necessary. In this way the available modalities of treatment can be applied so as to improve survival. Herein, a current 'state-of-the-art' of surgical indications and results for HCC is given.
肝细胞癌（HCC）的发病率日益上升，通常发生于肝硬化肝脏。若不治疗，预后严峻，唯一的治愈性治疗方法是手术切除。肝脏节段性手术的实际应用、超声及其他成像技术的使用、患者选择标准以及围手术期技术和术后护理的改进，都有助于提高肝脏手术的效果。如今，肝硬化肝脏切除术的死亡率低于10%，预计5年生存率可达50%。然而，治愈性切除存在局限性：肝内复发使得严格的随访成为必要。通过这种方式，可以应用现有的治疗方法来提高生存率。本文给出了肝细胞癌手术指征和结果的当前“最新进展”。
