Isshiki K, Nonami T, Kishimoto W, Katoh H, Akaza K, Harada A, Nakao A, Takagi H
Dept. of Surgery II, Nagoya University School of Medicine.
Gan To Kagaku Ryoho. 1990 Aug;17(8 Pt 2):1634-7.
From January 1980 to March 1990, 399 cases of primary liver cancer (hepatocellular carcinoma 357, cholangiocellular carcinoma 42) and 148 cases of metastatic liver cancer were treated in our hospital. Some 222 of H.C.C (hepatocellular carcinoma), 20 of C.C. (cholangiocellular carcinoma) and 42 of metastatic liver cancer were resected; 24 of H.C.C, 2 of C.C and 22 of metastatic cancer received adjuvant hepatic arterial chemotherapy, in which anti-cancer drugs were administered with oily contrast medium Lipiodol in hepatic artery. The relationship between operative findings and postoperative prognosis was studied in 168 resected H.C.C cases and risk factors for recurrence were determined. Risk factors are TW(+), which means that the cancer remains macroscopically within 1 cm of surgical margin; IM(+), which means intrahepatic metastasis exists; more than Vp2, which means tumor embolus exists in the second or more proximal branch of the portal vein; and Fc(-), which means lack of capsule formation. In 132 cases with the risk factors, the survival rate of 19 cases with adjuvant arterial chemotherapy was significantly higher than that of 113 cases without it. In the cases of liver metastasis of colon cancer, resection of metastases and adjuvant hepatic arterial chemotherapy improved the prognosis.
1980年1月至1990年3月，我院共收治原发性肝癌399例（肝细胞癌357例，胆管细胞癌42例）及转移性肝癌148例。其中肝细胞癌切除222例，胆管细胞癌切除20例，转移性肝癌切除42例；肝细胞癌24例、胆管细胞癌2例及转移性肝癌22例接受了辅助性肝动脉化疗，即在肝动脉内将抗癌药物与油性造影剂碘油混合注入。对168例接受手术切除的肝细胞癌患者的手术所见与术后预后的关系进行了研究，并确定了复发的危险因素。危险因素包括TW(+)，即肉眼观察癌灶距手术切缘1cm以内；IM(+)，即存在肝内转移；Vp2以上，即门静脉二级及以上分支存在癌栓；Fc(-)，即无包膜形成。在132例有危险因素的患者中，19例接受辅助动脉化疗患者的生存率显著高于113例未接受辅助动脉化疗的患者。在结肠癌肝转移病例中，切除转移灶并辅以肝动脉化疗可改善预后。
