Sigurdardottir Rakel Hekla, Birgisson Helgi, Jonasson Jón Gunnlaugur, Haraldsdottir Kristin Huld
Faculty of Medicine, University of Iceland.
Icelandic Cancer Registry.
Laeknabladid. 2022 Sep;108(9):395-402. doi: 10.17992/lbl.2022.09.705.
Cancers in the liver, bile duct system, gallbladder as well as metastases of the liver, have poor prognosis. Their treatment is comparable, with surgery being the most widespread, available curative treatment. Surgical treatment is anatomical or non-anatomical resection of the liver where the tumor and the adjacent liver tissue are removed.
MATERIALS/METHODS: A list of patients diagnosed with cancer in the liver, bile duct system, gallbladder or metastases of the liver, during the time period 2013-2017, was obtained from the Icelandic Cancer Registry. Additional information was retrieved from medical records and entered into the electronic quality registration forms of Landspítalinn. A comparison was made between Sweden and Iceland.
In total 108 patients were diagnosed with primary cancer of the liver, of which 24 (22%) underwent liver surgery. Of 264 diagnosed with liver metastases 38 (14%) underwent surgical treatment. A total of 63% of all reported cases were discussed at a multidisciplinary team meeting in Iceland but 93% in Sweden (p<0.0001). A sum of 29 patients (43%) developed complications within 30 days of surgery. Number of partial liver resections per 100.000 inhabitants were 2-8 in Iceland versus 4-13 in Sweden. The difference was even more apparent in patients with liver metastases.
Liver surgeries performed in Iceland seem to be comparable to Sweden in terms of complications and post operative mortality. In Iceland, considerably fewer operations are performed per capita, especially on liver metastases which could be explained by the fact that fewer patients are discussed at multidisciplinary team meetings.
发生于肝脏、胆管系统、胆囊的癌症以及肝脏转移瘤，预后较差。它们的治疗方法类似，手术是最广泛应用的可治愈性治疗手段。手术治疗是对肝脏进行解剖性或非解剖性切除，即切除肿瘤及相邻的肝组织。
材料/方法：从冰岛癌症登记处获取了2013年至2017年期间被诊断患有肝脏、胆管系统、胆囊癌症或肝脏转移瘤的患者名单。从病历中获取了更多信息，并录入了Landspítalinn的电子质量登记表。对瑞典和冰岛进行了比较。
共有108例患者被诊断为原发性肝癌，其中24例（22%）接受了肝脏手术。在264例被诊断为肝转移瘤的患者中，38例（14%）接受了手术治疗。冰岛所有报告病例中有63%在多学科团队会议上进行了讨论，而瑞典为93%（p<0.0001）。共有29例患者（43%）在术后30天内出现并发症。冰岛每10万居民的部分肝切除例数为2至8例，而瑞典为4至13例。在肝转移瘤患者中，这种差异更为明显。
冰岛实施的肝脏手术在并发症和术后死亡率方面似乎与瑞典相当。在冰岛，人均手术例数要少得多，尤其是肝转移瘤手术，这可能是因为在多学科团队会议上讨论的患者较少。
