Farges O, Regimbeau J M, Belghiti J
Department of Hepato-biliary and Digestive Surgery, Beaujon Hospital, University Paris VII, Clichy, France.
Hepatogastroenterology. 1998 Aug;45 Suppl 3:1275-80.
Liver resection of hepatocellular carcinoma (HCC) is associated with a high incidence of recurrence, that has a poor prognosis.
Assess the rationale for and result of an aggressive treatment of recurrence following resection of HCC.
Retrospective analysis of 132 patients with recurrent HCC with special reference to the topography and time of onset of recurrence as well as outcome following treatment of these recurrences. Case-control analysis of the efficacy of repeat hepatectomy and its influence on the long term prognosis of patients with recurrent tumor.
Sixty seven percent of the recurrences were exclusively intrahepatic and half of these were limited in size and number. The 5-year survival rate following treatment of limited intrahepatic recurrence by repeat hepatectomy, arterial chemoembolization or percutaneous ethanol injection was 30%. Repeat hepatectomies improved the long term outcome of patients with recurrent HCC.
An aggressive approach to tumor recurrence is currently the best way to improve the long term outcome following resection of HCC.
肝细胞癌（HCC）肝切除术后复发率高，预后较差。
评估HCC切除术后积极治疗复发的理论依据及结果。
回顾性分析132例复发性HCC患者，特别关注复发的部位、时间以及这些复发灶治疗后的结果。对再次肝切除术的疗效及其对复发性肿瘤患者长期预后的影响进行病例对照分析。
67%的复发仅局限于肝内，其中一半在大小和数量上有限。通过再次肝切除术、动脉化疗栓塞或经皮乙醇注射治疗局限性肝内复发后的5年生存率为30%。再次肝切除术改善了复发性HCC患者的长期预后。
目前，积极应对肿瘤复发是改善HCC切除术后长期预后的最佳方法。
