原发性巨大肝癌的综合治疗186例分析

目的 探讨巨大肝癌综合治疗的方法和疗效,以进一步提高肝癌的治疗效果.方法 回顾性分析近5年我院收治的186例原发性巨大肝癌的治疗情况,其中125例行手术治疗,包括19例先行经皮股动脉穿刺肝动脉化疗(TACE)后再行Ⅱ期肿瘤切除,32例单纯肿瘤切除治疗,69例肿瘤切除后行周围静脉或腹腔内化疗等综合治疗,手术不能切除5例;其中非手术治疗61例,包括43例行TACE治疗;18例行周围静脉或腹腔内化疗.结果 手术并发症发生率11%,术后1个月内死亡1例,单纯手术组1、2、3年的生存率分别为78.1%,62.5%,46.5%,手术联合综合治疗组1、2、3年的生存率分别为87.5%,76.1%,60.2%.结论 巨大肝癌以手术切除为主的综合治疗方法可提高患者的远期生存率.

Comprehensive therapy for giant primary liver cancer:a report of 186 cases

Objective To investgate the effect of surgical treatment and comprehensive therapy for giant primary liver cancer. Methods One hundred and eighty-six cases of gaint primary liver cancer received surgical treatment and comprehensive therapy in recent 5 years ware analyzed retrospectively. Among them, 120 cases were treated with various modes of hepatectomy; The other 61 nonresectable cases were treated with various combinations of therapy, such as TACE, venus and intraperitoneal chemotherapy. Results The postoperative complications was 11%. For the resection group, the 1-, 2- and 3 year survival rates were 78.1%, 62.5 % and 46.5 %, respectively. For the resection and intraperitoneal chemotherapy group, the 1-, 2- and 3 year survival rates were 87.5% ,76.1% and 60.2% ,respectively. Conclusion Surgery-predominant comprehensive therapy is effective modiality for resectable PLC. Postoperative individualized comprehensive treatment can prevent tumor recurrence and improve postoperative effect.