Yokoyama I, Takagi H
Department of Surgery II, Nagoya University School of Medicine, Japan.
Semin Surg Oncol. 1996 May-Jun;12(3):212-6. doi: 10.1002/(SICI)1098-2388(199605/06)12:3<212::AID-SSU12>3.0.CO;2-Z.
Liver transplantation for advanced hepatocellular carcinoma (HCC) continues to be a subject of debate mostly due to a uniformly high failure rate secondary to recurrence. However, accumulating experiences have enabled detailed analysis of the prognostic factors affecting patient outcome. Clinicopathological factors affecting survival have been reported to include tumor size, number, lobar distribution, vascular invasion, lymphnode metastasis, and histologic type such as fibrolamellar variant of HCC. Poor prognosis has been associated with advanced stage of the tumor, particularly pTNM stage IV. Many transplant centers now use a protocol of adjuvant chemotherapy with reasonable success, although experiences are limited. Better understanding in tumor biology, particularly of the role of immunosuppression affecting tumor growth, will provide further success in the treatment of HCC by liver transplantation.
晚期肝细胞癌（HCC）的肝移植仍然是一个备受争议的话题，主要原因是复发导致的失败率一直居高不下。然而，不断积累的经验使得对影响患者预后的预后因素进行详细分析成为可能。据报道，影响生存的临床病理因素包括肿瘤大小、数量、叶分布、血管侵犯、淋巴结转移以及组织学类型，如HCC的纤维板层变体。预后不良与肿瘤晚期有关，尤其是pTNM分期IV期。尽管经验有限，但现在许多移植中心采用辅助化疗方案取得了一定的成功。对肿瘤生物学的更好理解，特别是免疫抑制对肿瘤生长作用的理解，将为肝移植治疗HCC带来更大的成功。
