原发性肝癌并门静脉癌栓132例治疗分析

目的　探讨不同方法治疗原发性肝癌合并门静脉癌栓的疗效。　方法　回顾性分析我院 1995年 1月~2003年 12月收治的 132例肝癌合并门静脉癌栓的临床资料。根据不同方法分成 4组:保守治疗组 19例,化疗组 38例,手术切除组 20例,综合治疗组 55例。　结果　保守治疗组、化疗组、手术切除组与综合治疗组中位生存时间分别为 3. 3、6. 8、10. 0、13. 8个月。综合治疗组术后 0. 5、1、2和 3年生存率分别为 52. 7%、36. 4%、30. 9%和 12. 7%,明显高于其他三组(P<0. 01)。肿瘤大小、肝切缘有无癌残留及术后化疗次数是影响手术切除后疗效的重要因素。　结论　门静脉癌栓患者能耐受手术者应积极行肝癌切除并术中取栓治疗,而手术切除加术后化疗的疗效最佳。

Treatment for Primary Hepatic Cancer with Portal Vein Tumor Emboli (132 Cases Report)

Objective To investigate the therapeutic eff ec t of different treatment for primary hepatic cancer (PHC) with portal vein tumor emboli. Methods 132 cases of PHC with portal vein tumor emboli admitted from January 1995 to December 2003 were retrospectively reviewe d, which were divided into four groups according to the different treatment: con servative treatment group (Group A, n=19), chemotherapy group (Group B, n=38), s urgical resection group (Group C, n=20), and surgical resection combined with ch emotherapy group (Group D, n=55). Results The me dian survival periods group A, B, C and D were 3.3, 6.8, 10.0 and 13.8 mon ths respectively. The 0.5, 1-, 2-, 3-year survival rate in Group D was 52.7%, 3 6.4%, 30.9% and 12.7% respectively, which were significantly higher than those of the other three groups ( P <0.05). Tumor size, resection mar gin and chemotherapy times significantly associated with the therapeutic effect. Median survival period remarkably increased with the increasing of chemotherapy times. Conclusions Aggressively hepatecto my and tumor embolectomy are recommendable for PHC patient with portal vein tumo r emboli who can endure operation. The surgical effect can be further improved w hen followed with chemotherapy.