Nonami T, Isshiki K, Katoh H, Kishimoto W, Harada A, Nakao A, Takagi H
Department of Surgery II, Nagoya University School of Medicine, Japan.
Ann Surg. 1991 Mar;213(3):222-6. doi: 10.1097/00000658-199103000-00007.
The relationship between operative findings of hepatoma and the postoperative prognosis was studied to clarify indications for adjuvant hepatic arterial chemotherapy after hepatectomy. The results of adjuvant hepatic arterial chemotherapy using 0.4 mg/kg of doxorubicin and 0.12 mg/kg of mitomycin C and infusion of 5-fluorouracil were reported. One hundred sixty patients who had undergone hepatectomy for hepatoma were studied. In the operative findings of hepatoma, with a surgical margin of less than 10 mm, intrahepatic metastasis, tumor embolus in the second or more proximal branch of the portal vein, or lack of capsule formation related to the prognosis were the risk factors for recurrence. In 132 patients with these risk factors the survival rate of 19 patients with adjuvant arterial chemotherapy was significantly higher than for the 113 patients without it. Adjuvant hepatic arterial chemotherapy thus may be an effective therapy and should be studied prospectively in patients undergoing hepatectomy for high-risk hepatoma.
为明确肝切除术后辅助性肝动脉化疗的适应证，对肝癌手术结果与术后预后的关系进行了研究。报告了使用0.4mg/kg阿霉素、0.12mg/kg丝裂霉素C及输注5-氟尿嘧啶进行辅助性肝动脉化疗的结果。对160例行肝癌肝切除术的患者进行了研究。在肝癌手术结果中，手术切缘小于10mm、肝内转移、门静脉第二级或更高级分支内的肿瘤栓子或无包膜形成与预后相关，是复发的危险因素。在132例有这些危险因素的患者中，19例接受辅助性动脉化疗患者的生存率显著高于113例未接受化疗患者。因此，辅助性肝动脉化疗可能是一种有效的治疗方法，应对高危肝癌肝切除术患者进行前瞻性研究。
