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早期肝细胞癌的治疗:迈向个体化治疗。

Treatment of early hepatocellular carcinoma: Towards personalized therapy.

机构信息

BCLC Group, Liver Unit, CIBEREHD, IDIBAPS, Hospital Clínic, Barcelona, Spain.

出版信息

Dig Liver Dis. 2010 Jul;42 Suppl 3:S242-8. doi: 10.1016/S1590-8658(10)60512-9.

Abstract

In recent years, the wide implementation of surveillance programs has led to diagnose HCC at earlier stages, when curative options can be applied. In order to obtain the best results, treatment indication should take into account the estimation of baseline life expectancy. Patients at an early stage are those with single HCC or up to three nodules <3 cm with preserved liver function (Child-Pugh A-B) and no cancer related symptoms. These patients should be evaluated for any of the therapies that can offer complete responses with potential long-term cure, as reflected by a 5 years survival superior to 50-70%. These include surgical resection, liver transplantation and ablation. We briefly reviewed therapeutic management for early HCC, taking into account that any recommendation should be delivered in the clinical setting and based on an individualised evaluation of each patient.

摘要

近年来,广泛实施的监测计划使得 HCC 能够在早期阶段得到诊断,此时可以采用治愈性的治疗方案。为了获得最佳的效果,治疗的适应证应该考虑到患者的预期基线生存时间。早期 HCC 患者是指那些单个 HCC 或最多 3 个结节,且直径<3cm,肝功能(Child-Pugh A-B)正常,且没有癌症相关症状的患者。对于这些患者,应评估所有能够提供完全缓解并具有潜在长期治愈效果的治疗方法,这些方法可使 5 年生存率超过 50%-70%,包括手术切除、肝移植和消融。我们简要回顾了早期 HCC 的治疗管理,需要注意的是,任何建议都应该在临床环境中提供,并基于对每位患者的个体化评估。

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