Department of Digestive Surgery, Toranomon Hospital and Okinaka Memorial Institute of Medical Research, Tokyo, Japan.
Surgery. 2013 May;153(5):727-31. doi: 10.1016/j.surg.2012.03.031. Epub 2012 Jun 15.
Peritoneal metastases from hepatocellular carcinoma are common; they are found in as many as 18% of autopsy cases. Effective treatment for peritoneal metastases, however, has not yet been established.
We resected peritoneal metastases 12 times in 9 patients with hepatocellular carcinoma. We assessed the clinical course and outcome of these patients to determine the effectiveness of resecting peritoneal metastases and the factors related to survival.
The 1-, 3-, and 5-year survival rates were 58%, 52%, and 42%, respectively. Four patients survived for longer than 2 years without recurrence or with controlled recurrence confined to the liver. Three patients receiving palliative resection had a poor prognosis, with survivals of only 4, 9, and 12 months.
Operative resection should be an option for selected patients with peritoneal metastases from hepatocellular carcinoma. Resection of peritoneal metastases should be considered in patients whose primary liver neoplasm is under control and who have no metastases in other organs.
肝细胞癌的腹膜转移很常见；在多达 18%的尸检病例中都有发现。然而，对于腹膜转移还没有有效的治疗方法。
我们对 9 例肝细胞癌患者的腹膜转移灶进行了 12 次切除术。我们评估了这些患者的临床过程和结果，以确定切除腹膜转移灶的有效性和与生存相关的因素。
1、3、5 年生存率分别为 58%、52%和 42%。4 例患者存活时间超过 2 年，且无复发或仅局限于肝脏的复发得到控制。3 例接受姑息性切除的患者预后较差，存活时间分别为 4、9 和 12 个月。
对于患有肝细胞癌腹膜转移的特定患者，手术切除应该是一种选择。对于原发性肝肿瘤得到控制且其他器官无转移的患者，应考虑切除腹膜转移灶。
