Section of Transplantation, Department of Surgery, Washington University School of Medicine, Washington University, 660 South Euclid Avenue, Campus Box 8109, St Louis, MO 63130, USA.
Clin Liver Dis. 2011 May;15(2):353-70, vii-x. doi: 10.1016/j.cld.2011.03.008.
Liver resection remains the standard therapy for solitary hepatocellular carcinoma in patients with preserved hepatic function. In well-selected patients, 5-year survival rates are good and can approach that of liver transplantation for early-stage disease. Patient selection is critical to optimizing therapeutic benefit, and the health of the native liver must be considered in addition to tumor characteristics. Hepatic recurrence after resection is common. The difficulty lies in deciding which patients with chronic liver disease and small solitary tumors are best served by resection and which should proceed with transplant evaluation; this is the focus of this article.
肝切除术仍然是肝功能正常的单发肝细胞癌患者的标准治疗方法。在选择良好的患者中,5 年生存率良好,可接近早期疾病的肝移植。患者选择对于优化治疗效果至关重要,除了肿瘤特征外,还必须考虑到肝脏的健康状况。切除术后肝内复发很常见。困难在于确定哪些患有慢性肝病和小单发肿瘤的患者最适合接受切除术,哪些患者应进行移植评估;这是本文的重点。