Kanematsu T, Matsumata T, Takenaka K, Yoshida Y, Higashi H, Sugimachi K
Department of Surgery II, Kyushu University Hospital, Fukuoka, Japan.
Br J Surg. 1988 Mar;75(3):203-6. doi: 10.1002/bjs.1800750305.
Curative resections were performed on 121 patients with primary hepatocellular carcinoma from 1975 to 1986 at Kyushu University Hospital, Japan. Up to August 1987 there was a recurrence in 41, detected between 4 and 86 (mean 20) months after surgery. Intrahepatic recurrences were the most common (82 per cent). There was no statistically significant correlation between size of the primary tumour and interval from surgery to detection of recurrence (r = -0.09). Serial measurement of serum alpha-fetoprotein (AFP) was useful for the detection of recurrences. However, the levels of AFP seem to be a non-specific, unreliable test for such patients since this tumour marker showed different ranges before the primary surgery and at the time of recurrence in 5 of the 41 patients (12 per cent). Postoperative chemotherapy with oral 5-fluorouracil had no apparent preventative effect on the recurrence. A second curative resection was effective in four patients, and three survived for over 2 years; the longest survival time is 9 years after the second procedure.
1975年至1986年期间，日本九州大学医院对121例原发性肝细胞癌患者实施了根治性切除术。截至1987年8月，41例出现复发，复发时间在术后4至86个月（平均20个月）之间。肝内复发最为常见（82%）。原发肿瘤大小与手术至复发检测间隔之间无统计学显著相关性（r = -0.09）。血清甲胎蛋白（AFP）的系列检测对复发检测有用。然而，AFP水平对这类患者似乎是一项非特异性、不可靠的检测，因为在41例患者中的5例（12%）中，该肿瘤标志物在初次手术前和复发时显示出不同范围。口服5-氟尿嘧啶的术后化疗对复发无明显预防作用。二次根治性切除术对4例患者有效，3例存活超过2年；二次手术后最长存活时间为9年。
