Lang H, Heinrich S, Bartsch F, Hüttl F, Baumgart J, Mittler J
Klinik für Allgemein‑, Viszeral- und Transplantationschirurgie, Universitätsmedizin, Johannes Gutenberg-Universität Mainz, Langenbeckstraße 1, 55131, Mainz, Deutschland.
Internist (Berl). 2020 Feb;61(2):147-157. doi: 10.1007/s00108-020-00754-8.
The most frequent primary hepatic malignancies are hepatocellular carcinoma (HCC) and intrahepatic cholangiocarcinoma (intrahepatic cholangiocellular adenocarcinoma [iCCA]). For HCC in cirrhosis, liver transplantation offers the advantage of a complete hepatectomy radically removing all tumorous tissue along with the surrounding cirrhotic parenchyma, which is otherwise associated with a very high risk of recurrence. For HCC in non-cirrhotic livers and iCCA, liver resection is the treatment of choice. Nowadays, even extended resections can be performed with low mortality in experienced centers. Surgical therapy is more and more embedded into multimodal treatment concepts and decision making should be interdisciplinary as for other gastrointestinal tumors.
最常见的原发性肝脏恶性肿瘤是肝细胞癌(HCC)和肝内胆管癌(肝内胆管细胞腺癌[iCCA])。对于肝硬化患者的HCC,肝移植具有彻底切除所有肿瘤组织以及周围肝硬化实质的优势,否则复发风险会非常高。对于非肝硬化肝脏中的HCC和iCCA,肝切除是首选治疗方法。如今,在经验丰富的中心,即使是扩大切除也能以低死亡率进行。手术治疗越来越多地融入多模式治疗理念,决策应像其他胃肠道肿瘤一样跨学科进行。