根据改良的日本综合分期评分选择肝细胞癌的治疗方式。
Selection of treatment modality for hepatocellular carcinoma according to the modified Japan Integrated Staging score.
作者信息
Nanashima Atsushi, Masuda Junichi, Miuma Satoshi, Sumida Yorihisa, Nonaka Takashi, Tanaka Kenji, Hidaka Shigekazu, Sawai Terumitsu, Nagayasu Takeshi
机构信息
Division of Surgical Oncology, Department of Translational Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki 852-8501, Japan.
出版信息
World J Gastroenterol. 2008 Jan 7;14(1):58-63. doi: 10.3748/wjg.14.58.
AIM
To compare the prognosis of patients who underwent hepatectomy and ablation using the modified Japan Integrated Staging score (mJIS).
METHODS
We examined the clinicopathologic records and patient outcomes in 278 HCC patients including 226 undergoing hepatectomy and 52 undergoing ablation therapy.
RESULTS
Cirrhosis was more frequent in the ablation group. Tumor size, number and presence of vascular invasion were significantly higher in the operation group compared to the ablation group. The local recurrence rate adjacent to treated lesions was significantly higher in the ablation group compared to the operation group (P < 0.05). The 3- and 5-year survival rates in the ablation and the operation group were 66% and 78%, and 50% and 63%, respectively, but not significantly different. Over 50% survival rates were observed in patients with a mJIS score of 0-2 in both groups. However, survival rates with a score of 3-5 in both groups were significantly lower.
CONCLUSION
According to the mJIS system, both local treatments could be selected for patients with a score of 0-2. However, for patients with a score more than 3, liver transplantation might be a better option in patients with HCC.
目的
使用改良日本综合分期系统（mJIS）比较接受肝切除术和消融术患者的预后。
方法
我们检查了278例肝癌患者的临床病理记录和患者预后，其中226例接受肝切除术，52例接受消融治疗。
结果
消融组肝硬化更为常见。与消融组相比，手术组的肿瘤大小、数量和血管侵犯情况明显更高。与手术组相比，消融组治疗部位附近的局部复发率明显更高（P<0.05）。消融组和手术组的3年和5年生存率分别为66%和78%，以及50%和63%，但差异不显著。两组中mJIS评分为0-2的患者生存率超过50%。然而，两组中评分为3-5的患者生存率明显较低。
结论
根据mJIS系统，评分为0-2的患者可以选择两种局部治疗方法。然而，对于评分超过3的患者，肝移植可能是肝癌患者更好的选择。
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