Zhou X D, Tang Z Y, Yu Y Q, Yang B H, Lu J Z, Lin Z Y, Ma Z C
Liver Cancer Institute, Shanghai Medical University, China.
Gan To Kagaku Ryoho. 1995 Aug;22 Suppl 3:286-9.
This paper reports the long-term results of multimodality treatment in 1639 patients with pathologically proven primary liver cancer (PLC) over the past three decades. In this series, patients in subclinical stage constituted 23.9% (391/1639), moderate stage 63.0% (1032/1639), and late stage 13.2% (216/1639). There were 381 patients (23.2%) with small PLC (< = 5 cm). The PLC was coexistent with liver cirrhosis in 86.4% (1416/1639). The 5-year survival after resection of PLC was 45.5% for the whole series (n = 896), and 62.7% for patients with a tumor < = 5 cm (n = 345). The 5-year survival after hepatic artery ligation (HAL) and hepatic artery infusion (HAI) (n = 124) was 18.1%, while the 5-year survival after palliative resection (n = 175) was 12.5%. The 5-year survival of 40 patients receiving second-look resection after cytoreduction therapy was 68.4%. Cryosurgery was performed on 107 PLC patients, the 5-year survival being 22.0% for the whole series, and 48.8% for the 32 patients with small PLC. The 5-year recurrence rate after resection was 55.3%. The 5-year survival after reoperation for recurring tumor (n = 90) was 40.8%. It is suggested that surgery remains the modality of choice, and it plays a more important role in the treatment of PLC. The results of palliative surgery (HAL + HAI) seem better than those of palliative resection; combined multimodality treatment and second-look resection, and new surgical techniques might offer hope for unresectable advanced PLC.
本文报告了过去三十年中1639例经病理证实的原发性肝癌（PLC）患者接受多模式治疗的长期结果。在该系列中，亚临床期患者占23.9%（391/1639），中期患者占63.0%（1032/1639），晚期患者占13.2%（216/1639）。有381例（23.2%）小肝癌患者（直径≤5 cm）。PLC合并肝硬化的患者占86.4%（1416/1639）。整个系列（n = 896）PLC切除术后的5年生存率为45.5%，肿瘤直径≤5 cm的患者（n = 345）为62.7%。肝动脉结扎（HAL）和肝动脉灌注（HAI）（n = 124）后的5年生存率为18.1%，而姑息性切除（n = 175）后的5年生存率为12.5%。40例接受细胞减灭治疗后二次手术切除的患者5年生存率为68.4%。对107例PLC患者进行了冷冻手术，整个系列的5年生存率为22.0%，32例小肝癌患者为48.8%。切除术后的5年复发率为55.3%。复发性肿瘤再次手术（n = 90）后的5年生存率为40.8%。提示手术仍然是首选的治疗方式，在PLC治疗中发挥着更重要的作用。姑息性手术（HAL + HAI）的结果似乎优于姑息性切除；联合多模式治疗和二次手术切除以及新的手术技术可能为无法切除的晚期PLC带来希望。
