巨大肝癌的外科治疗

目的 探讨巨大肝癌(直径≥10cm)手术切除的安全性、可行性和治疗结果。方法 分析我院手术治疗大肝癌103例的效果。比较巨大肝癌与直径＜10cm一般肝癌切除组(34例)、以及巨大肝癌的切除组(68例)和非切除组(35例)的手术并发症、生存率。结果 巨大肝癌切除组与一般肝癌切除组的手术时间与出血量均无明显差异，手术并发症、死亡率三组间也无差异。一般肝癌组、巨大肝癌切除组与非切除组术后1、3、5年生存率分别为78．64％、53．73％、23．76％；72．8％、47．84％、21．26％及32．56％、11．37％、5．45％。后两者差异有显著的统计学意义(P＜0．05)。结论 对巨大肝癌的手术切除应持积极态度，一期切除能获得良好的治疗效果，如同时施行综合治疗可提高巨大肝癌远期疗效。

Surgical treatment of large hepatocellular carcinoma

ObjectiveTo evaluate the safety, reliability and effect of hepatectomy in treatment of large hepatocellular carcinoma (HCC). MethodsThe clinical data of 103 cases of large HCC treated in our hospital were retrospectively analyzed. The general condition, postoperative complications and survival rate were compared among 34 patients with resected tumor <10 cm (group A), 68 with the resected tumor > 10cma (group B) and 35 not receiving hepatectomy (group C). ResultsNo significant differences in duration of operation, perioperative bleeding, postoperative complications and death rate were found among the 3 groups. The 1-, 3- and 5-year survival rates were significantly higher in groups A and B than in group C (P<0.05). ConclusionsThe attitude towards surgical treatment of large HCC should be active. One-phase resection can achieve satisfactory results. Meanwhile, comprehensive treatments after the operation can result in better long-term outcome.