原发性肝癌切除术后肝外脏器复发转移的临床研究

目的:了解影响原发性肝癌(PLC)患者术后肝外脏器转移性复发的因素,并提出相应治疗措施.方法:通过临床回顾性调查获取明确诊断的PLC术后发生远处转移的46例病人,对初次手术时的临床病理因素、出现转移复发灶时的临床因素及复发后的治疗因素进行统计处理,分析其与复发后生存率的关系.结果:①PLC术后,肝外转移复发最常见的脏器为肺、骨骼,且大多伴有残肝复发.②有肝外转移复发时,生存率明显低于单纯肝内复发者.③与复发后生存率有关的因素包括:临床病期、肿瘤分化程度、及时有效地控制残肝复发灶及切除肝外转移复发灶.结论:对肝外脏器转移复发灶的治疗原则是:在积极有效地控制残肝复发灶的前提下,尽可能切除转移灶,可望延长复发后生存时间.

Clinical study on extrahepatic metastases after partial hepatectomy for primary liver cancer

Objective:To investigate the predisposing factors for extrahepatic recurrente metastases after partial hepatic resection for primary liver cancer(PLC) and to pose correlative management for the metastases.Methods:46 patients with PLC coexisting with extrahepatic metastases following partial hepatectomy were included in this retrospective clinic study. Clinicopathological factors of patients after the first hepatic resection,clinical factors detected to have extrahepatic recurrence and treatment factors against recurrence lesions were handled statistically. The correlation between these factors and survival rate of patients after recurrence was analyzed.Results:The commonest extrahepatic metastatic organs included the lungs and bones. The most of these sites was concomitant with the remnant liver recurrence. The survival rate of patients with extrahepatic metastases was significantly lower compared to that of having remnant liver recurrence only. The relative factors with survival rate of patients who underwent hepatic resection and were detected to have extrahepatic metastases included:clinical stages,cancer degree of differentiation,well controlled recurrence lesion in the remnant liver and resection of extrahepatic metastases.Conclusion:If the metastases in the remnant liver can be well controlled,the extrahepatic metastases resection should be the treatment method of choice in these patients.