Inoue Y, Ishida T, Murakami T, Nakamura H
Department of Radiology, Toyonaka Municipal Hospital, Japan.
Gan To Kagaku Ryoho. 1998 Oct;25(12):1857-64.
The prognoses of 110 patients with advanced hepatocellular carcinoma (HCC) in stages III and IV were studied retrospectively. These patients were treated mainly by transarterial chemoembolization (TAE) or chemoinfusion using Lipiodol. Some of the patients underwent percutaneous ethanol injection therapy (PEIT) or tumor resection following TAE. Hepatic function, tumor stage, vascular involvement, type of tumor invasion, number of tumors and number of treatments affected the prognosis of the patients. The prognosis was better in the Child A group than in Child B and C. In the Child C group, the prognosis was markedly poor, and was least affected by any treatment. The prognoses in the patients with multiple nodular lesions, massive or diffuse lesions, were much poorer than those with a few nodular lesions. Tumor thrombosis in the central portal vein and distant metastasis greatly exacerbated the therapeutic results. Repeat therapy yielded a favorable therapeutic result when hepatic function was tolerable. Surgical intervention and PEIT were an effective therapy in a few patients. In advanced HCC, liver function and tumor extension should be fully evaluated, and it is important to determine the most effective therapeutic modalities to improve the survival of patients.
对110例Ⅲ期和Ⅳ期晚期肝细胞癌（HCC）患者的预后进行了回顾性研究。这些患者主要接受经动脉化疗栓塞术（TAE）或使用碘油的化疗灌注治疗。部分患者在TAE后接受了经皮乙醇注射治疗（PEIT）或肿瘤切除术。肝功能、肿瘤分期、血管受累情况、肿瘤侵犯类型、肿瘤数量和治疗次数影响患者的预后。Child A组的预后优于Child B组和Child C组。在Child C组中，预后明显较差，且受任何治疗的影响最小。多发结节性病变、大块或弥漫性病变患者的预后比少数结节性病变患者差得多。肝门静脉主干肿瘤血栓形成和远处转移极大地恶化了治疗效果。当肝功能可耐受时，重复治疗可产生良好的治疗效果。手术干预和PEIT对少数患者是有效的治疗方法。在晚期HCC中，应充分评估肝功能和肿瘤扩展情况，确定最有效的治疗方式对提高患者生存率很重要。
