Zhou X D, Yu Y Q, Tang Z Y, Yang B H, Lu J Z, Lin Z Y, Ma Z C, Xu D B, Zhang B H, Zheng Y X
Liver Cancer Institute, Shanghai Medical University, People's Republic of China.
Hepatogastroenterology. 1993 Aug;40(4):333-6.
During the last 16 years, radical resection was performed in 392 patients with hepatocellular carcinoma (HCC). Eight patients died within 30 days after resection. The other 384 patients were discharged from hospital and closely followed for 6 to 195 months. By December 1991, 185 patients had developed a recurrent tumor, the 1-, 3-, and 5-year recurrence rates being 15.0%, 45.4%, and 55.3%, respectively. Ninety of the 185 patients underwent reoperation, including second hepatic resection (65 cases), cryosurgery (8 cases), resection of lung metastasis (6 cases), hepatic artery ligation and infusion chemotherapy (2 cases), intratumor ethanol injection (3 cases), microwave coagulation plus intratumor ethanol injection (2 cases), and exploration (4 cases). The survival rate of these 90 patients was significantly better than that of 95 patients who were treated by other palliative methods, the 5-year survival rate being 63.4% as compared with 28.6% after the first resection (P < 0.01), and 40.8% vs. 2.2% after recurrence (P < 0.01), respectively. These results suggest that reoperation for recurrent HCC might be an important approach to prolonging survival further after hepatic resection.
在过去16年中，对392例肝细胞癌（HCC）患者实施了根治性切除术。8例患者在切除术后30天内死亡。其余384例患者出院后接受了6至195个月的密切随访。截至1991年12月，185例患者出现了肿瘤复发，1年、3年和5年复发率分别为15.0%、45.4%和55.3%。185例复发患者中有90例接受了再次手术，包括二次肝切除（65例）、冷冻手术（8例）、肺转移灶切除（6例）、肝动脉结扎及灌注化疗（2例）、瘤内乙醇注射（3例）、微波凝固加瘤内乙醇注射（2例）以及探查（4例）。这90例患者的生存率显著高于采用其他姑息性治疗方法的95例患者，5年生存率分别为63.4%（首次切除后为28.6%，P < 0.01）以及40.8%（复发后为2.2%，P < 0.01）。这些结果表明，复发性HCC再次手术可能是肝切除术后进一步延长生存期的重要方法。
