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肝细胞癌术后腹腔转移的外科治疗:单中心10年经验

Surgical Treatment of Postoperative Abdominal Metastases of Hepatocellular Carcinoma: 10-Year Experience in a Single Center.

作者信息

Fang Jiong-Ze, Yang Yong, Zhu Hong-Da, Sun Jian-Nan, Mi Hong-Chao, Lu Cai-De

机构信息

Department of Hepatopancreatobiliary Surgery, Ningbo Medical Centre Lihuili Hospital, Ningbo University, Ningbo, Zhejiang, People's Republic of China.

出版信息

Cancer Manag Res. 2021 Nov 20;13:8673-8683. doi: 10.2147/CMAR.S328250. eCollection 2021.

Abstract

OBJECTIVE

The significance of surgical treatment was analyzed by retrospectively collecting data on the re-resection of intra-abdominal metastases after hepatocellular carcinoma (HCC) surgery in our center over the past 10 years.

METHODS

The clinical and pathological data of 15 patients who developed intra-abdominal metastases after HCC resection and underwent re-resection from January 2010 to January 2020 were collected to analyze the patients' characteristics and prognosis.

RESULTS

Of the 15 cases of abdominal metastasis, the majority (8 cases) had greater omental metastasis. There were 4 cases of mesenteric metastases, 1 case of abdominal wall metastasis, 1 case of mesenteric plus rectal wall metastasis, and 1 case of colon and mesenteric metastasis. The 1-year, 3-year, and 5-year disease-free survival (DFS) rates were 31.1%, 23.3%, and 11.7%, respectively. The 1-year, 3-year, and 5-year overall survival rates were 93.3%, 28.7%, and 19.1%, respectively. Three patients are currently surviving disease-free, with survival times of 130.4 months, 43.3 months, and 9.4 months, respectively.

CONCLUSION

Although the current guidelines do not recommend surgical resection as the preferred treatment for postoperative abdominal metastases of HCC, surgical resection is recommended for patients with limited or solitary metastasis in the abdominal cavity.

摘要

目的

通过回顾性收集本中心过去10年肝细胞癌(HCC)手术后腹腔内转移灶再次切除的数据,分析手术治疗的意义。

方法

收集2010年1月至2020年1月期间15例HCC切除术后发生腹腔内转移并接受再次切除的患者的临床和病理数据,分析患者特征及预后。

结果

15例腹腔转移病例中,大部分(8例)为大网膜转移。肠系膜转移4例,腹壁转移1例,肠系膜加直肠壁转移1例,结肠和肠系膜转移1例。1年、3年和5年无病生存率(DFS)分别为31.1%、23.3%和11.7%。1年、3年和5年总生存率分别为93.3%、28.7%和19.1%。目前有3例患者无病生存,生存时间分别为130.4个月、43.3个月和9.4个月。

结论

尽管目前的指南不推荐将手术切除作为HCC术后腹腔转移的首选治疗方法,但对于腹腔内转移局限或孤立的患者,建议进行手术切除。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3085/8612661/27cb5bb900bb/CMAR-13-8673-g0001.jpg

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