Belghiti Jacques
Chirurgie hépatobiliaire, pancréatique et transplantation, Hôpital Beaujon, 100, boulevard du Général Leclerc 92118 Clichy Cédex, France.
Bull Acad Natl Med. 2012 Jan;196(1):97-102; discussion 102-3.
HCC is frequent and difficult to treat, especially in patients with underlying chronic liver disease The risk of recurrence is very high. The best curative treatment for patients with limited tumors is liver transplantation (LT), an option restricted to rich countries and selected patients with a low risk of recurrence. Other curative treatments include partial liver resection in patients with excellent liver function, and radiofrequency ablation of tumors measuring less than 5 cm. Multiple tumors can be treated with transcatheter arterial chemoembolization or, more recently, 90Y radiotherapy. All these treatments may be combined in patients on the waiting list for LT Despite its potentially severe side effects, the new multikinase inhibitor sorafenib improves survival in the terminal phase.
肝癌常见且难以治疗，尤其是在患有潜在慢性肝病的患者中。复发风险非常高。对于肿瘤局限的患者，最佳的根治性治疗方法是肝移植（LT），但这一选择仅限于富裕国家以及复发风险较低的特定患者。其他根治性治疗方法包括肝功能良好患者的部分肝切除术，以及对直径小于5厘米的肿瘤进行射频消融。对于多个肿瘤，可以采用经动脉化疗栓塞术治疗，或者最近采用的90Y放射治疗。所有这些治疗方法都可以在等待肝移植的患者中联合使用。尽管新型多激酶抑制剂索拉非尼有潜在的严重副作用，但它能提高终末期患者的生存率。
