Mamada Yasuhiro, Tajiri Takashi, Akimaru Koho, Yoshida Hiroshi, Taniai Nobuhiko
The First Department of Surgery, Nippon Medical School, Tokyo, Japan.
Hepatogastroenterology. 2004 Jan-Feb;51(55):234-6.
BACKGROUND/AIMS: Resection is the treatment of choice for hepatocellular carcinoma. However, relatively few patients with hepatocellular carcinoma are surgical candidates. The efficacy of a radiologic hepatectomy, achieved by combined embolization of the arterial and portal tumor blood supply, was determined and compared to surgical hepatectomy in a retrospective analysis.
The records of 32 patients treated for hepatocellular carcinoma between 1989 and 1992 were reviewed. The outcome in 15 patients treated with combined selective segmental portal vein embolization and hepatic artery embolization without hepatectomy (Embolization group) was compared with the outcome in 17 patients who under went curative hepatic resection (Resection group). The recurrence-free and cumulative survival rates were compared in the two groups.
Except for a greater number of men in the Resection Group (p=0.03), the demographics and clinical characteristics of the two groups were similar at baseline. There was no patient who died within 30 days of treatment. The recurrence-free survival rates after embolization and resection were 20.8 and 23.4% at 5 years, respectively. The corresponding cumulative survival rates were 23.2 and 51.3%.
Combined embolization without hepatectomy may be a viable alternative to curative hepatectomy for selected patients with hepatocellular carcinoma.
背景/目的：肝切除术是肝细胞癌的首选治疗方法。然而，相对较少的肝细胞癌患者适合手术。在一项回顾性分析中，确定了通过联合栓塞动脉和门静脉肿瘤供血实现的放射学肝切除术的疗效，并与手术肝切除术进行了比较。
回顾了1989年至1992年间接受肝细胞癌治疗的32例患者的记录。将15例接受选择性节段性门静脉栓塞和肝动脉栓塞但未行肝切除术的患者（栓塞组）的结果与17例接受根治性肝切除术的患者（切除组）的结果进行比较。比较两组的无复发生存率和累积生存率。
除切除组男性人数较多外（p=0.03），两组的人口统计学和临床特征在基线时相似。没有患者在治疗后30天内死亡。栓塞和切除后的5年无复发生存率分别为20.8%和23.4%。相应的累积生存率分别为23.2%和51.3%。
对于某些肝细胞癌患者，不行肝切除术的联合栓塞可能是根治性肝切除术的可行替代方案。
Zotero 插件