Bennett B C, Selby R, Bahnson R R
Division of Urology, University of Pittsburgh Medical Center, Pennsylvania, USA.
J Urol. 1995 Sep;154(3):972-4.
More than 900 patients who underwent hepatic resections were reviewed to identify those whose liver resections were due to involvement by renal cell carcinoma.
Three patients with direct hepatic extension of the renal cell cancer underwent radical nephrectomy with en bloc partial hepatectomy, while 1 with a metachronous recurrence 3 years after nephrectomy underwent right triple lobe hepatectomy. There were no postoperative complications.
Of the en bloc resections 2 showed sarcomatoid features on histopathological examination. These patients experienced rapid disease progression and died. The remaining 2 patients with typical clear cell carcinoma have no evidence of disease.
Experience with these 4 patients has demonstrated that hepatic resection is technically feasible and associated with acceptable morbidity rates. Surgical management should be considered in patients with the uncommon presentation of renal cell carcinoma and localized hepatic involvement.
对900余例接受肝切除术的患者进行回顾性研究，以确定那些因肾细胞癌累及而接受肝切除术的患者。
3例肾细胞癌直接侵犯肝脏的患者接受了根治性肾切除术联合整块部分肝切除术，1例肾切除术后3年出现异时性复发的患者接受了右三叶肝切除术。术后无并发症发生。
在整块切除的病例中，2例在组织病理学检查中表现出肉瘤样特征。这些患者疾病进展迅速并死亡。其余2例典型透明细胞癌患者无疾病证据。
这4例患者的经验表明，肝切除术在技术上是可行的，且发病率可接受。对于肾细胞癌罕见表现且肝脏局限性受累的患者，应考虑手术治疗。
