原发性肝癌术后复发246例再治疗的近期疗效

目的探讨不同治疗方法对复发性肝癌患者治疗效果的影响。方法回顾性分析我院246例复发性肝癌患者的临床资料，38例行再次切除术，其中复发性肝癌单纯根治性手术切除18例；复发．性肝癌手术切除联合综合治疗20例；经皮肝动脉插管栓塞化疗（TACE）62例；146例患者给予保守治疗。结果1、3,5年生存率手术切除组分别为76．3％、394％及25．8％；TACE治疗组分别为53．2％、19.6%及9．3％；保守治疗组分别为37．7％、8．0％及1．5％，手术切除组与TACE治疗组及保守治疗组的生存率差异有统计学意义（P均〈0．05）。结论复发性肝癌二次手术切除治疗仍为首选方法，手术切除联合综合治疗是目前复发性肝癌再治疗的理想治疗模式，对患者的无瘤生存率及生存率均有所提高，并降低肝内再次复发，延长患者生存时间。

Short-term therapeutic effect of re-operation on 246 patients with postoperative recurrent primary hepatic carcinoma

Objective To explore the effects of different therapies in patients with postoperative recurrent primary hepatic carcinoma （PHC）. Methods Clinical data of 246 postoperative recurrent PHC patients were analyzed retrospectively.Of these, 18 underwent hepatectomy again,20 underwent hepatectomy again combined with comprehensive therapy, 62 were treated with transcatheter arterial chemoembolization（TACE）,and 146 were given conservative therapy. Results Survival rates in the lst,3rd and 5th years were 76.3% ,39.4% and 25.8% for patients who underwent hepatectomy again,compared to 53.2%, 19.6% and 9.3% for patients treated with TACE. The corresponding rates for patients given conservative therapy were 37.7%, 8.0% and 1.5%.The survival rates differed significantly among the three groups（P〈0.05）. Conclusions Secondary surgical resection is still the preferred method for recurrent PHC, and surgical excision combined with comprehensive treatment is the best treatment.It is associated with higher survival rate and tumor-free survival,lower intrahepatic PHC relapse, and longer survival time.