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[肝细胞癌腹膜转移的手术切除——三例报告]

[Surgical Resection for Peritoneal Metastasis in Hepatocellular Carcinoma-A Report of Three Cases].

作者信息

Nakano Tetsuya, Sakata Jun, Ando Takuya, Yuza Kizuki, Soma Daiki, Hirose Yuki, Katada Tomohiro, Miura Kohei, Takizawa Kazuyasu, Kobayashi Takashi, Ichikawa Hiroshi, Nagahashi Masayuki, Shimada Yoshifumi, Kameyama Hitoshi, Wakai Toshifumi

机构信息

Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences.

出版信息

Gan To Kagaku Ryoho. 2018 Dec;45(13):1949-1951.

Abstract

Peritoneal metastasis is relatively rare in patients with hepatocellular carcinoma(HCC). No consensus has been reached regarding the treatment of this type of metastasis. Herein, we report 3 patients who underwent resection of peritoneal metastasis due to HCC. Case 1: A 48-year-old man underwent hepatectomy twice and radiofrequency ablation(RFA)once for HCC. Eight years after the initial resection, he underwent resection of peritoneal metastasis in the pelvic floor. He is alive with disease 17 months after the last operation. Case 2: A 71-year-old man with a history of percutaneous ablation therapy for HCC 3 times underwent hepatectomy for recurrent HCC. During the laparotomy, a peritoneal metastatic tumor was found near the live tumor, and simultaneous resection of both the tumors was performed. The patient died of recurrent disease 20 months after the last resection. Case 3: A 58-year-old man underwent hepatectomy for HCC and RFA for its recurrence. Peritoneal metastasis that invaded the duodenum was detected 8 years after the hepatectomy. Although the metastatic tumor was resected, he died of the carcinoma 2 months after the resection. We concluded that resection of peritoneal metastasis provides a survival benefit for selected patients with HCC.

摘要

腹膜转移在肝细胞癌(HCC)患者中相对少见。对于这类转移的治疗尚未达成共识。在此,我们报告3例因HCC接受腹膜转移灶切除术的患者。病例1:一名48岁男性因HCC接受了两次肝切除术和一次射频消融(RFA)治疗。首次切除术后8年,他接受了盆底腹膜转移灶切除术。最后一次手术后17个月,他仍带瘤生存。病例2:一名71岁男性有3次HCC经皮消融治疗史,因复发性HCC接受肝切除术。剖腹手术期间,在肝肿瘤附近发现一个腹膜转移瘤,遂同时切除了这两个肿瘤。最后一次切除术后20个月,患者死于疾病复发。病例3:一名58岁男性因HCC接受肝切除术,复发后接受RFA治疗。肝切除术后8年检测到侵犯十二指肠的腹膜转移。尽管切除了转移瘤,但他在切除术后2个月死于癌症。我们得出结论,对于部分HCC患者,切除腹膜转移灶可带来生存获益。

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