Ibrahim Salleh, Roychowdhury Anupama, Hean Tay Khoon
Department of General Surgery, Changi General Hospital, 2 Simei Street 3, Changi, Singapore 507027.
Am J Surg. 2007 Jul;194(1):17-22. doi: 10.1016/j.amjsurg.2006.06.051.
Long-term survival after hepatectomy for hepatocellular carcinoma is still poor because of tumor recurrence especially in the liver remnant. The risk factors for intrahepatic recurrence after liver resection are studied in our cohort of patients.
A retrospective analysis from a prospective database was performed on 76 consecutive successful hepatectomies for hepatocellular carcinoma.
Twenty-two patients had intrahepatic recurrence. The following were not found to be risk factors for recurrence: age, sex, race, number of segments resected, and mean operating time. By using multivariate analysis, serum aspartate transaminase level, more than 1 hepatocellular carcinoma nodule, and presence of tumor thrombi were found to be significant risk factors.
Patients who with these risk factors should undergo close follow-up to detect recurrence early; treatment with reresection, chemoembolization, or radiofrequency ablation can be considered.
肝细胞癌肝切除术后的长期生存率仍然很低,原因是肿瘤复发,尤其是在肝残余部分。我们对一组患者研究了肝切除术后肝内复发的危险因素。
对前瞻性数据库中的76例连续成功进行的肝细胞癌肝切除术进行回顾性分析。
22例患者出现肝内复发。未发现以下因素为复发危险因素:年龄、性别、种族、切除的肝段数量和平均手术时间。通过多变量分析,发现血清天冬氨酸转氨酶水平、超过1个肝细胞癌结节以及肿瘤血栓的存在是显著的危险因素。
有这些危险因素的患者应密切随访以便早期发现复发;可考虑再次切除、化疗栓塞或射频消融治疗。