Takagi H, Uehara M, Sakurai S, Yamada S, Takayama H, Saitoh S, Ojima T, Yamada T, Abe T, Kobayashi S
Department of Internal Medicine, Maebashi Red Cross Hospital.
Nihon Gan Chiryo Gakkai Shi. 1990 Apr 20;25(4):757-69.
One hundred and one cases of hepatocellular carcinoma (HCC) treated in Maebashi Red Cross Hospital from May 1984 to August 1987 were classified according to the therapy and progression of the disease and were investigated on their prognosis. Furthermore, "long survived group" in which, patients survived for more than one year were compared with "short survived group" in which patients died within one month after non-surgical treatment. In operated patients, the prognosis was the best, but the rate of operable cases was only 13.9%. In patients with stage IV, one year survival rate was significantly low. In patients with portal trunk invasion (Vp4), or with Child C that was the poorest functional reserve of the liver, one year survival rate was also significantly low in comparison with patients with other stages or other Child's classification. In HCC patients treated with transcatheter arterial embolization (TAE), the prognosis tended to be poor as stage and portal invasion progressed, but in regard to reserve function of the liver, the prognosis was not so poor in patients of Child C significantly as in cases of A or B. The comparisons between long and short survived group were as follows. a) In 17 cases belong to long survived group, mean survival period was 24 months and the longest one was 4 years and 10 months. On the other hand, in 10 cases belong to short survived group, mean survival period was 17 days, the shortest one was 3 days. b) The main reason of inoperability in long survived group was progression of the tumor. Complications such as diabetes mellitus, advanced age and rejection of treatment by the patient were the other reasons of in operability. In almost half of the patients in short survived group, the tumor progression and low functional reserve of liver were found in 4 patients. c) In short survived group, esophageal varices were more common and functional reserve of the liver was poorer than in long survived group. In short survived group, LDH and total bilirubin were significantly higher than those of long survived group, but there was no significant differences in transaminase value and ICG retention in 15 minutes. d) In short survived group, extent of the tumor in liver and portal invasion were advanced. Three cases of this group (30%) had distant metastasis. e) In long survived group, the main reason of death was hepatic failure. Renal failure, or pulmonary complications were also found in short survived group.(ABSTRACT TRUNCATED AT 400 WORDS)
1984年5月至1987年8月在前桥红十字医院接受治疗的101例肝细胞癌（HCC）患者，根据疾病的治疗方法和进展进行分类，并对其预后进行了调查。此外，将存活超过一年的“长期存活组”患者与非手术治疗后一个月内死亡的“短期存活组”患者进行了比较。接受手术的患者预后最佳，但可手术病例的比例仅为13.9%。IV期患者的一年生存率显著较低。门静脉主干侵犯（Vp4）或肝功能储备最差的Child C级患者，与其他分期或其他Child分级的患者相比，一年生存率也显著较低。在接受经导管动脉栓塞术（TAE）治疗的HCC患者中，随着分期和门静脉侵犯的进展，预后往往较差，但就肝脏储备功能而言，Child C级患者的预后不像A或B级患者那样差。长期存活组和短期存活组的比较如下。a）在属于长期存活组的17例患者中，平均生存期为24个月，最长为4年10个月。另一方面，在属于短期存活组的10例患者中，平均生存期为17天，最短为3天。b）长期存活组中无法手术的主要原因是肿瘤进展。糖尿病、高龄和患者拒绝治疗等并发症是无法手术的其他原因。在短期存活组中，几乎一半的患者出现肿瘤进展，4例患者肝功能储备低下。c）在短期存活组中，食管静脉曲张更常见，肝脏储备功能比长期存活组差。在短期存活组中，乳酸脱氢酶（LDH）和总胆红素显著高于长期存活组，但转氨酶值和15分钟吲哚氰绿（ICG）潴留率无显著差异。d）在短期存活组中，肝脏肿瘤范围和门静脉侵犯程度进展。该组3例患者（30%）有远处转移。e）在长期存活组中，主要死亡原因是肝衰竭。短期存活组中也发现肾衰竭或肺部并发症。（摘要截断于400字）
