Shimamura T, Une Y, Nakajima Y, Sato N, Matsushita M, Kamiyama T, Uchino J
First Dept. of Surgery, Hokkaido University School of Medicine.
Gan To Kagaku Ryoho. 1994 Sep;21(13):2229-32.
One hundred and eighty-nine patients with hepatocellular carcinoma (HCC) underwent hepatectomy since 1987 to 1992 in our institute. Recurrences were detected on residual liver in 84 patients up to December 1993. Sixty-seven of 84 patients were treated with re-resection (group-O, n = 11), transarterial embolization (TAE) combined with percutaneous ethanol injection therapy (PEIT) (group-TP, n = 13), TAE alone (group-T, n = 34) and intraarterial chemotherapy (group-IA, n = 9). Among these 67 cases, the efficacy of treatment for recurrences was investigated. There was no significant difference in age, positive ratio of hepatitis B virus, ICG R15 and percentage of underlying liver cirrhosis among the 4 groups. However, the frequency of patients with 2 nodules or less, was significantly higher in group-O than in other groups. Cumulative 1-, 2- and 3-year survival rates (%) were 88.9, 64.8 and 51.9 in group-O, 92.1, 55.4 and 55.4 in group-TP, 70.9, 49.6 and 31.0 in group-T, and 16.9, 0 and 0 in group-IA, respectively. The survival rate after recurrences in group-TP was higher than in group-IA and group-T, and almost equivalent to that of group-O. Either re-resection or TAE combined with PEIT might assure- a favorable prognosis in patients with recurrent HCC.
1987年至1992年期间，我院对189例肝细胞癌（HCC）患者实施了肝切除术。截至1993年12月，84例患者的残余肝脏出现复发。84例患者中的67例接受了再次切除（O组，n = 11）、经动脉栓塞（TAE）联合经皮乙醇注射治疗（PEIT）（TP组，n = 13）、单纯TAE（T组，n = 34）和动脉内化疗（IA组，n = 9）。在这67例病例中，对复发的治疗效果进行了研究。4组患者在年龄、乙肝病毒阳性率、吲哚菁绿滞留率15分钟（ICG R15）以及潜在肝硬化百分比方面无显著差异。然而，O组中2个及以下结节患者的比例显著高于其他组。O组1年、2年和3年累积生存率（%）分别为88.9、64.8和51.9，TP组为92.1、55.4和55.4，T组为70.9、49.6和31.0，IA组为16.9、0和0。TP组复发后的生存率高于IA组和T组，几乎与O组相当。再次切除或TAE联合PEIT可能确保复发性HCC患者有良好的预后。
