Knox Clayton D, Anderson Christopher D, Lamps Laura W, Adkins R Benton, Pinson C Wright
Departments of Surgery, Vanderbilt University Medical Center, Nashville, Tennessee 37232-4753, USA.
Ann Surg Oncol. 2003 Dec;10(10):1171-5. doi: 10.1245/aso.2003.04.533.
Primary hepatic carcinoid tumors (PHCTs) are extremely rare, and fewer than 50 cases have been reported in the English-language literature. We report a patient with a PHCT and review the cases in the literature.
Our patient presented with symptoms and underwent liver resection for PHCT and regional lymph node metastasis. He underwent two more liver resections over the following 7 years for recurrent PHCT. Cases reported in the English-language literature were reviewed and survival analysis was performed with the Kaplan-Meier method. The survival impacts of age, gender, tumor foci, extrahepatic metastasis, unilobar versus bilobar disease, and type of preoperative treatment were determined by means of log-rank test.
Our patient has been free of symptoms for 14 years of follow-up and free of disease for 8 years of follow-up. Forty-eight cases of PHCT were found in the literature, and 92% of these patients underwent resection. Actuarial 5- and 10-year survival for all patients was 78% and 59%, respectively, whereas for resected patients, 10-year survival was 68%. The administration of preoperative chemotherapy, radiation therapy, or chemoembolization did not impact survival, nor did age, gender, presence of extrahepatic metastasis, number of tumors, or distribution of the tumor within the liver.
Resection is the treatment of choice for PHCT and has provided favorable outcomes. Resection for PHCT can be performed in most patients and offers long-term survival.
原发性肝类癌肿瘤（PHCTs）极为罕见，英文文献报道的病例不足50例。我们报告1例PHCT患者，并对文献中的病例进行回顾。
我们的患者出现症状后接受了PHCT及区域淋巴结转移的肝切除术。在接下来的7年里，他因复发性PHCT又接受了两次肝切除术。对英文文献报道的病例进行回顾，并采用Kaplan-Meier法进行生存分析。通过对数秩检验确定年龄、性别、肿瘤灶、肝外转移、单叶与双叶病变以及术前治疗类型对生存的影响。
我们的患者在14年的随访中无症状，在8年的随访中无疾病。文献中发现48例PHCT病例，其中92%的患者接受了切除术。所有患者的5年和10年精算生存率分别为78%和59%，而接受切除术患者的10年生存率为68%。术前化疗、放疗或化疗栓塞的应用对生存无影响，年龄、性别、肝外转移的存在、肿瘤数量或肿瘤在肝脏内的分布也无影响。
手术切除是PHCT的首选治疗方法，已取得良好疗效。大多数PHCT患者可行手术切除，并可实现长期生存。
