Farges O, Belghiti J
Service de Chirurgie Digestive et de Transplantation Hépatique, Université Paris VII, Hôpital Beaujon, Clichy.
Ann Chir. 1998;52(6):535-42.
Despite the recent development of percutaneous ethanol injection and liver transplantation, liver resection remains the reference treatment for hepatocellular carcinoma (HCC). The two drawbacks of this treatment are the risk associated with surgery and the high recurrence rate. Both are related to the almost constant presence of a chronic underlying liver disease. The risk of surgery has decreased significantly over the past 10 years and is currently less than 10%, even after a major hepatectomy, provided that cirrhosis is compensated (Child A) and that there is no superimposed chronic active hepatitis. Recurrence is usually related to de novo carcinogenesis Adjuvant and neoadjuvant therapies have no clearly demonstrated benefit. However, postoperative follow-up is mandatory as some recurrences are arnenable to local treatment, particularly rehepatectomy that has an efficacy comparable to that of first hepatectomy.
尽管最近经皮乙醇注射和肝移植技术有所发展，但肝切除仍然是肝细胞癌（HCC）的标准治疗方法。这种治疗方法的两个缺点是与手术相关的风险和高复发率。这两者都与慢性潜在肝病几乎持续存在有关。在过去10年中，手术风险已显著降低，目前即使在进行大肝切除术后，风险也低于10%，前提是肝硬化得到代偿（Child A级）且无叠加的慢性活动性肝炎。复发通常与新发癌变有关。辅助治疗和新辅助治疗尚未明确显示出益处。然而，术后随访是必不可少的，因为一些复发适合局部治疗，特别是再次肝切除术，其疗效与首次肝切除术相当。
