Matsuda Y, Ito T, Oguchi Y, Nakajima K, Izukura T
Department of Surgery, Otemae Hospital, Osaka, Japan.
Ann Surg. 1993 Jan;217(1):28-34. doi: 10.1097/00000658-199301000-00006.
From 1979 to 1991, 100 patients with hepatocellular carcinoma (HCC) underwent a curative hepatic resection in our institution. Five patients died within 1 month, and four patients died after longer than 1 month hospitalization. The remaining 91 patients were closely followed. Intrahepatic recurrences became obvious in 36 (40%) of these 91 patients during the follow-up period. Second operation was carried out on 22 patients, and the re-extirpation of HCCs was performed on 16 patients. Pure ethanol injection into the tumor associated with implantation of the Infuse-A-Port (Infusaid Inc., Norwood, MA) for intra-arterial infusion of anti-cancer agents was performed on the remaining six patients. Of these 22 patients, 15 are still alive, eight being free of HCC and seven with the disease, for 13 to 92 months after the first operation. The cumulative survival rate of 22 patients with repeated operations was significantly better than that of 14 patients who were treated conservatively (p < 0.05). The adequate surgical management of recurrent HCC is considered as most important in achieving better prognosis of HCC.
1979年至1991年期间，我院对100例肝细胞癌（HCC）患者进行了根治性肝切除术。5例患者在1个月内死亡，4例患者在住院超过1个月后死亡。其余91例患者接受密切随访。在随访期间，这91例患者中有36例（40%）出现肝内复发。对22例患者进行了二次手术，其中16例患者再次切除了肝癌。其余6例患者对肿瘤进行了纯乙醇注射，并植入了Infuse-A-Port（Infusaid公司，马萨诸塞州诺伍德）用于动脉内输注抗癌药物。在这22例患者中，15例仍然存活，其中8例无肝癌，7例患有肝癌，自首次手术后存活了13至92个月。22例接受重复手术患者的累积生存率明显优于14例接受保守治疗患者的累积生存率（p<0.05）。复发性肝癌的适当手术治疗被认为是实现肝癌更好预后的最重要因素。
