Kawarada Y, Imai T, Iwata M, Yokoi H, Noguchi T, Mizumoto R
First Department of Surgery, Mie University School of Medicine, Tsu, Japan.
Cancer Chemother Pharmacol. 1992;31 Suppl:S13-9. doi: 10.1007/BF00687098.
The effect of multidisciplinary therapy for hepatocellular carcinoma (HCC) was evaluated in 121 resected cases. The 5-year survival was 100% for absolute curative resection (12 cases), 59.1% for relative curative resection (n = 37) and 10.9% for relative non-curative resection (n = 59). However, none of the patients survived for more than 3 years after absolute non-curative resection (n = 13). The non-recurrence in the preoperative TAE groups was different from that in non-TAE groups undergoing absolute and relative curative resection. The 1- and 3-year non-recurrence rates for relative non-curative resection were 92.3% and 53.8%, respectively, for the preoperative TAE group and 56.1% and 28.1%, respectively for the non-TAE group. These data show that preoperative TAE is effective in relative non-curative resection. Functional disturbances of the coagulation-fibrinolysis system in cirrhotic patients were improved after PSE. All patients undergoing hepatectomy after PSE had an uneventful postoperative course, including well-maintained function of the coagulation-fibrinolysis system and a decrease in splenic volume. At 1 year after hepatectomy, cirrhotic patients with critical liver function and poor coagulation-fibrinolysis showed appreciable hepatic regeneration. One patient died of hepatic failure 1 year after the operation. In recurrent HCC, the 1-, 2- and 3-year survival values after reresection were 100%, 75.0% and 25.0%, respectively. The respective values following TAE were 79.0%, 42.0% and 9.0%. Three cases of recurrent HCC were effectively treated, i.e., two patients achieved a partial response and one showed no change, by continuous intra-arterial infusion of 5-FU and lentinan with intermittent one-shot injections of epirubicin using a subcutaneous infusion pump. These three patients are alive at 1 year and 7 months, 1 year and 4 months and 6 months after the treatment, respectively.
对121例接受肝切除术的肝细胞癌（HCC）患者评估了多学科治疗的效果。绝对根治性切除术（12例）患者的5年生存率为100%，相对根治性切除术（n = 37）患者为59.1%，相对非根治性切除术（n = 59）患者为10.9%。然而，绝对非根治性切除术（n = 13）患者无一存活超过3年。术前经动脉栓塞化疗（TAE）组与接受绝对和相对根治性切除术的非TAE组的无复发生存情况不同。术前TAE组相对非根治性切除术的1年和3年无复发生存率分别为92.3%和53.8%，非TAE组分别为56.1%和28.1%。这些数据表明术前TAE在相对非根治性切除术中有效。经皮肝穿刺门静脉栓塞术（PSE）后，肝硬化患者凝血 - 纤溶系统的功能障碍得到改善。所有接受PSE后肝切除术的患者术后过程平稳，包括凝血 - 纤溶系统功能维持良好和脾体积减小。肝切除术后1年，肝功能临界且凝血 - 纤溶功能差的肝硬化患者显示出明显的肝再生。1例患者术后1年死于肝衰竭。在复发性HCC中，再次切除术后的1年、2年和3年生存率分别为100%、75.0%和25.0%。TAE后的相应生存率分别为79.0%、42.0%和9.0%。3例复发性HCC患者通过使用皮下输注泵持续动脉内输注5 - 氟尿嘧啶和香菇多糖并间歇性一次性注射表柔比星得到有效治疗，即2例患者部分缓解，1例病情无变化。这3例患者分别在治疗后1年7个月、1年4个月和6个月存活。
