Ouchi K, Matsubara S, Fukuhara K, Tominaga T, Matsuno S
First Department of Surgery, Tohoku University School of Medicine, Sendai, Japan.
Am J Surg. 1993 Sep;166(3):270-3. doi: 10.1016/s0002-9610(05)80972-9.
We analyzed the results of 19 patients who had intrahepatic recurrence of hepatocellular carcinoma (HCC) among 47 patients who were discharged from the hospital after having a hepatic resection in order to evaluate the factors affecting recurrence and survival. Recurrence-free survival rates were 80%, 44%, and 28% at 1, 3, and 5 years, respectively. Of the 19 patients with recurrence, 14 had multiple lesions, and 16 of the recurrences were detected within 3 years of surgery. None of the following factors correlated with recurrence: hepatic function; tumor size; presence of tumor capsule; capsular invasion; vascular invasion and intrahepatic metastasis; extent of hepatic resection; and resection with tumor-free margins. Patients having multiple recurrent HCCs, however, had larger-sized tumors at the time of resection than those with a solitary recurrence. The survival rates after recurrence were significantly better in patients with a solitary recurrence, and these patients were treated with transcatheter arterial embolization (TAE) therapy. Early detection as well as TAE for recurrent HCCs is necessary to improve long-term survival.
我们分析了47例肝切除术后出院患者中19例肝细胞癌（HCC）肝内复发患者的结果，以评估影响复发和生存的因素。1年、3年和5年的无复发生存率分别为80%、44%和28%。在19例复发患者中，14例有多个病灶，16例复发在术后3年内被检测到。以下因素均与复发无关：肝功能；肿瘤大小；肿瘤包膜的存在；包膜侵犯；血管侵犯和肝内转移；肝切除范围；以及切缘无肿瘤的切除。然而，有多个复发性HCC的患者在切除时的肿瘤比单发复发的患者更大。单发复发患者复发后的生存率明显更好，这些患者接受了经导管动脉栓塞（TAE）治疗。早期检测以及对复发性HCC进行TAE治疗对于提高长期生存率是必要的。
