Maraj R, Kew M C, Hyslop R J
Department of Medicine, University of the Witwatersrand, Johannesburg, South Africa.
Br J Surg. 1988 Apr;75(4):335-8. doi: 10.1002/bjs.1800750413.
The purpose of this analysis was to ascertain the resectability rate of symptomatic hepatocellular carcinoma in rural southern African black males. All 224 such patients proven to have hepatocellular carcinoma in a single hospital were included in the study. Of 205 patients undergoing a complete diagnostic work-up, 134 [65.3 per cent) were judged on clinical criteria to be inoperable, 23 (11.2 per cent) had pulmonary or osseous metastases, and 38 (18.5 per cent) proved on hepatic imaging and 5 (2.4 per cent) on hepatic arteriography to have an irresectable tumour. Thus, only five (2.4 per cent) of these patients proceeded to laparotomy. Another 7 patients who did not have an arteriogram, 9 with surgical emergencies, and 2 mistakenly believed to have an amoebic hepatic abscess also underwent laparotomy. Only 2 patients (0.9 per cent of 223) proved to have a resectable tumour. The extremely low resectability rate reinforces the urgent need for a surveillance programme to detect early tumours in high-risk members of this population.
本分析的目的是确定非洲南部农村黑人男性有症状肝细胞癌的可切除率。该研究纳入了一家医院确诊的所有224例此类患者。在205例接受完整诊断检查的患者中，134例（65.3%）根据临床标准判断为不可手术，23例（11.2%）有肺或骨转移，38例（18.5%）经肝脏影像学检查及5例（2.4%）经肝动脉造影证实有不可切除肿瘤。因此，这些患者中只有5例（2.4%）进行了剖腹手术。另外7例未进行动脉造影的患者、9例外科急症患者以及2例误被认为患有阿米巴肝脓肿的患者也接受了剖腹手术。仅2例患者（223例中的0.9%）被证实有可切除肿瘤。极低的可切除率凸显了迫切需要开展一项监测计划，以便在该人群的高危成员中检测早期肿瘤。
