Harada T, Kodama S, Matsuo K, Higuchi T, Nagai T, Ikeda S, Okazaki M
First Department of Surgery, School of Medicine, Fukuoka University, Japan.
Int Surg. 1993 Oct-Dec;78(4):284-7.
This study was designed to determine the criteria for curative resection in hepatectomy for large hepatocellular carcinoma. The extent of resection was closely related to recurrence rate, and complete removal of the involved segments was found to be essential for curative hepatectomy. Patients with satellite nodules had a high incidence of recurrence; in fact, carcinoma recurred in all patients, with satellite nodules scattered through more than one segment, despite whole tumor removal. However, curative resection could be achieved in patients with portal involvement confined to the second portal branches, when the tumor, including tumor thrombi, was removed en bloc. On the basis of these results, we define complete en bloc removal of the involved segments, including portal involvements, as curative resection, even though curative hepatectomy is not attainable in patients with satellite nodules in more than one segment and/or tumor thrombi in the first branches or truncus of the portal vein.
本研究旨在确定大肝细胞癌肝切除术中根治性切除的标准。切除范围与复发率密切相关，发现完整切除受累节段对于根治性肝切除术至关重要。有卫星结节的患者复发率较高；事实上，所有有卫星结节且分布于一个以上节段的患者，尽管肿瘤已全部切除，但仍会复发。然而，当肿瘤（包括瘤栓）整块切除时，门静脉受累局限于第二门静脉分支的患者可实现根治性切除。基于这些结果，我们将包括门静脉受累在内的受累节段的完整整块切除定义为根治性切除，尽管对于有一个以上节段卫星结节和/或门静脉第一分支或主干有瘤栓的患者无法实现根治性肝切除术。
