原发性肝癌的外科治疗体会

１９８５年４月至１９９６年１２月２０２例原发性肝癌行肝叶切除，均经手术和病理证实。伴肝硬化者占８７．１２５，有乙肝背景者１５２例，占７５．２４％。ＡＦＰ正常者６３例（３１．１８％）。化疗缩小后再切除１４例，复发再切除８例，术后复发灶注射无水酒精８例，术中均经胃网膜右静脉置管至门静脉化疗。多数行免疫治疗，１、３、５年生存率８５．８０％、５２．４６％、２０．２９％。作者认为，术中Ｂ超检查对小肝癌定位、

SURGICAL TREATMENT FOR PRIMARY LIVER CANCER

From April 1985 to December 1996,202 cases of patholgically proved primary hepatic carcinoma(PHC)were treated surgically by hepatic resection. 176 cases (87. 12% ) had liver cirrhosis while 152 cases had hepatitis background (75. 24% ). 63 cases (31. 18 % ) had AFP in normal range (<20ug). 14 cases reduced in size after chemotherapy had sequential tumor resection. 8 cases under- went tumor re-resection after local recurrence. The precutaneous ethanol injection(PEI) method was performed in 8 cases. All cases had transcatheteral infusion of chemotherapeutic agent combined with immunotherapy through right gastroepiploic vein. Of the 202 cases,the overall 1, 3, 5,years survival rate was 85. 80%, 52. 46 %, 20. 29 % respectively. The authors noted that Intraoperative Ultrasonograohy has its definite position in localizing small hepatic cancer;detecting satellite lesions around main tumor;discovering cancer-thrombi in portal vein and directing the selection of operative treatment. The application of curative surgery in combination with adjuvant therapy is important in treatment of PHC.