[肝尾状叶单发性肝细胞癌的肝切除术]

Hayashi Hiromitsu, Beppu Toru, Masuda Toshiro, Okabe Hirohisa, Komori Hiroyuki, Horino Kei, Ishiko Takatoshi, Takamori Hiroshi, Hirota Masahiko, Baba Hideo

Dept. of Gastroenterological Surgery, Faculty of Medical and Pharmaceutical Sciences, Kumamoto University.

Gan To Kagaku Ryoho. 2007 Nov;34(12):2090-2.

INTRODUCTION

Treatments of hepatocellular carcinoma (HCC) located in the caudate lobe have been difficult because of the unique anatomical location. Our objective was to evaluate the surgical outcomes of hepatic resection for a single HCC located in the caudate lobe.

METHODS

Between January 1999 and December 2005, 97 patients with a single HCC underwent hepatic resection at our department. Seven (7.2%) of the 97 patients had a single HCC located in the caudate lobe. The caudate lobe HCC was located in the spiegel lobe in 2 patients, the paracaval portion in 2, caudate process in 2 and a total caudate lobe in 1. The influence of the tumor location (caudate lobe origin) on the surgical outcomes was analyzed in comparison with the other site tumors.

RESULTS

The morbidity rate after hepatic resection for a single HCC in caudate lobe and the other lobes were 57% and 20%, respectively. The morbidity rate was significantly higher in the caudate lobe group (p < 0.05). The 3- and 5-year cumulative survival rates of the patients with a single caudate lobe HCC and the other lobes were 83.3%, 83.3%, 89% and 85.4%, respectively. Similarly, the 3- and 5-year cumulative disease free survival rates were 51.4%, 51.4%, 59.4% and 45.5%, respectively. There was no significant difference in both the cumulative survival rate and cumulative disease free survival rate.

CONCLUSIONS

Hepatic resection for a single HCC located in the caudate lobe was an effective treatment, being equal clinical outcomes to a single HCC in the other sites of the liver.

引言

由于尾状叶独特的解剖位置，位于尾状叶的肝细胞癌（HCC）的治疗一直很困难。我们的目的是评估肝切除治疗位于尾状叶的单个HCC的手术效果。

方法

1999年1月至2005年12月，97例单发HCC患者在我科接受了肝切除术。97例患者中有7例（7.2%）的单个HCC位于尾状叶。尾状叶HCC位于尾状叶 Spiegel叶2例，腔静脉旁部2例，尾状突2例，全尾状叶1例。与其他部位肿瘤相比，分析肿瘤位置（尾状叶起源）对手术效果的影响。

结果

尾状叶和其他叶单发HCC肝切除术后的发病率分别为57%和20%。尾状叶组的发病率明显更高（p<0.05）。单个尾状叶HCC患者和其他叶患者的3年和5年累积生存率分别为83.3%、83.3%、89%和85.4%。同样，3年和5年累积无病生存率分别为51.4%、51.4%、59.4%和45.5%。累积生存率和累积无病生存率均无显著差异。