中晚期肝癌切除后再以介入为主的综合治疗分析

目的 探讨肝癌切除后再以介入为主的综合治疗对中晚期肝癌的疗效。方法 对39例巨大肝癌累及第二或第三肝门,或伴有门静脉癌栓或胆管癌栓,切除原发癌灶并取出门脉、胆管癌栓,术后2周左右行介入为主的综合治疗。介入的次数依肝功能的恢复及肝癌的残留情况而定。结果 全组术后无重大并发症发生。AFP转阴23例,明显下降11例;9例明显残留癌灶病人,介入后AFP均显著下降。全组除1例术后3个月肝癌复发破裂出血死亡外,生存期大于6个月6例,1年10例,2年12例,3年7例,4年3例。结论 手术仍是巨大中晚期肝癌的有效治疗方法,手术后以介入为主的综合治疗是预防复发、提高生存率的有效措施之一。

Analysis of interventional treatment with combined therapy after hepatectomy of middle-advanced liver cancer

Objective To evaluate the value of interventional treatment with combined therapv in post-operation of hepatoma(HCC) .Methods From January 1997 to June 2001,39 patients with advanced HCC were treated using interventional treatment with combined therapv after operation. Results All patients survived without surgical mortality. The titer of AFP declined in 11 patients and turned negative in 23 patients. The titer of AFP in 9 patients of palliative resec-tion after interventional treatment was significantly declined. 1 patient died from bleeding of hepatoma recurrence, 6 cases survived for more than 6 months and 10,12,7,3 case for more than 1,2,3,4 years respectively. Conclusion Operation is stili effective for the advanced HCC, and post-operative combined therapv including interventional treatment can significantly improve the survival rate.