Inoue K, Makuuchi M, Takayama T, Harihara Y, Yamasaki S, Kosuge T, Yamamoto J, Shimada K, Hasegawa H
Second Department of Surgery, Faculty of Medicine, University of Tokyo, Japan.
Gan To Kagaku Ryoho. 1996 Jun;23(7):849-54.
Two hundred thirty-five patients with small hepato-cellular carcinomas (HCCs) (mixed hepatocellular and cholangiocellular carcinoma included) measuring no more than 3 cm in diameter treated by surgical resection between 1980 and 1990 were reviewed retrospectively. Ninety-nine percent of the patients also had chronic hepatitis and 73% were diagnosed histologically as having liver cirrhosis. The operative and hospital mortality rates were 0.4% and 1.3%, respectively. The number of tumors, intrahepatic metastasis and vascular invasion were significant prognostic factors. Overall the 1-,3-and 5-year survival rates (operative deaths included) were 93.2%, 72. 7%, and 49.7%, and those of 144 patients treated in the late 80s (1986-1990) were 93.6%, 76.3%, and 52. 1%, respectively. These results were appreciably better than those for percutaneous ethanol injection therapy (PEIT) and transcatheter arterial embolization therapy (TAE) reported previously. In particular, the survival of the patient with single tumor demonstrated a clear advantage of surgery. The selection of treatment modalities is discussed, and our present standard strategy for surgical treatment is described.
回顾性分析了1980年至1990年间接受手术切除的235例直径不超过3cm的小肝细胞癌（包括混合性肝细胞癌和胆管细胞癌）患者。99%的患者还患有慢性肝炎，73%经组织学诊断为肝硬化。手术死亡率和医院死亡率分别为0.4%和1.3%。肿瘤数量、肝内转移和血管侵犯是重要的预后因素。总体而言，1年、3年和5年生存率（包括手术死亡病例）分别为93.2%、72.7%和49.7%，80年代后期（1986 - 1990年）接受治疗的144例患者的生存率分别为93.6%、76.3%和52.1%。这些结果明显优于先前报道的经皮乙醇注射治疗（PEIT）和经导管动脉栓塞治疗（TAE）的结果。特别是，单肿瘤患者的生存显示出手术的明显优势。讨论了治疗方式的选择，并描述了我们目前的手术治疗标准策略。
