Martin J K, Moertel C G, Adson M A, Schutt A J
Arch Surg. 1983 May;118(5):537-42. doi: 10.1001/archsurg.1983.01390050021004.
Thirteen patients with functioning carcinoid syndrome and hepatic metastases were surgically treated. Localized hepatic metastases were resected in five patients, and diffuse hepatic metastases were treated with hepatic artery ligation in eight. There were no postoperative deaths, and follow-up ranged from six to 46 months. All patients were symptom-free after operation. In all patients with resection, levels of 5-hydroxyindoleacetic acid (5-HIAA) returned to normal or near normal, whereas in patients who underwent hepatic artery ligation, the average reduction in 5-HIAA level was 76%. Three patients died during the follow-up period--two of metastatic carcinoids and one without evidence of disease. The mean duration of response was 36 months for resection and 4.8 months for hepatic artery ligation. The addition of postoperative intra-arterial chemotherapy and sequential systemic chemotherapy may enhance the response to hepatic artery ligation.
13例患有功能性类癌综合征并伴有肝转移的患者接受了手术治疗。5例患者的局限性肝转移灶被切除，8例弥漫性肝转移患者接受了肝动脉结扎术。术后无死亡病例，随访时间为6至46个月。所有患者术后均无症状。所有接受切除术的患者，5-羟吲哚乙酸（5-HIAA）水平恢复正常或接近正常，而接受肝动脉结扎术的患者，5-HIAA水平平均降低76%。3例患者在随访期间死亡，2例死于转移性类癌，1例无疾病证据。切除术后反应的平均持续时间为36个月，肝动脉结扎术为4.8个月。术后动脉内化疗和序贯全身化疗可能会增强对肝动脉结扎术的反应。
