Lygidakis N J, Pothoulakis J, Konstantinidou A E, Spanos H
Department of Hepatobiliary-Pancreatic Surgery, Hellenic Anticancer Institute, St. Savas Hospital, Athens, Greece.
Anticancer Res. 1995 Mar-Apr;15(2):543-50.
Hepatocellular carcinoma remains a disease with poor prognosis. Liver resection, although the optimal method of management, is associated with a high incidence of intrahepatic tumour recurrence ranging between 50-70%, 12 to 18 months following surgery. This study assesses prospectively the results of liver resection as compared to liver resection combined with pre- and post-operative locoregional chemotherapy-immunotherapy in 40 patients suffering from hepatocellular carcinoma. Patients were randomly assigned to two groups. Group A (20 patients) had liver resection only, while Group B (20 patients) had liver resection combined with pre- and past-operative targeting locoregional chemotherapy-immunotherapy. Five (5) patients died in total: two from Group A and two from Group B, during the first 30 days following surgery due to reasons related to the procedure (post-operative liver failure in three, pulmonary embolism in one). The remaining patient from Group A died 10 months following liver resection due to intrahepatic tumour recurrence. From Group A, 17 patients are alive from 3 to 26 months after surgery. Of the 17 alive patients, 10 are free of disease and 7 show intrahepatic recurrence. Thus, tumour intrahepatic recurrence occurred in 8 patients of group A. From Group B, all 18 patients are alive and free of disease from 4 to 27 months after surgery. No patient died because of the disease nor has any patient shown intrahepatic tumour recurrence. As a conclusion of the present results, liver resection combined with pre- and post-operative targeting locoregional immunotherapy-chemotherapy appears to offer substantial advantages for patients undergoing surgery because of hepatocellular carcinoma.
肝细胞癌仍然是一种预后较差的疾病。肝切除术虽是最佳治疗方法，但术后12至18个月肝内肿瘤复发率高达50 - 70%。本研究前瞻性评估了40例肝细胞癌患者单纯肝切除术与术前及术后局部区域化疗 - 免疫治疗联合肝切除术的效果。患者被随机分为两组。A组（20例患者）仅接受肝切除术，而B组（20例患者）接受肝切除术并联合术前及术后局部区域靶向化疗 - 免疫治疗。共有5例患者死亡：A组2例，B组2例，均在术后前30天因与手术相关的原因死亡（3例术后肝衰竭，1例肺栓塞）。A组其余1例患者在肝切除术后10个月因肝内肿瘤复发死亡。A组17例患者术后存活3至26个月。在这17例存活患者中，10例无疾病，7例有肝内复发。因此，A组有8例患者发生肝内肿瘤复发。B组18例患者术后均存活，术后4至27个月无疾病。无患者因疾病死亡，也无患者出现肝内肿瘤复发。根据目前结果得出结论，对于因肝细胞癌接受手术的患者，肝切除术联合术前及术后局部区域免疫治疗 - 化疗似乎具有显著优势。
