原发性肝癌肝移植术围手术期辅助治疗的研究

目的:探讨围手术期辅助治疗在原发性肝癌肝移植中的意义。方法:回顾性分析36例原发性肝癌肝移植手术病例的临床资料,比较单纯行经肝动脉栓塞化疗(TACE)、TACE 经皮瘤内无水酒精注射(PEI),多电极射频治疗(RFA) TACE以及全身化疗等围手术辅助治疗措施对患者复发率及生存率的影响。结果:12例患者经辅助治疗后肿瘤直径缩小(66.7%),平均(4.8±1.2)cm,13例肿瘤临床分期降级。术后1、2、3年复发率分别为33.3%、47.2%、55.6%。TACE PEI、RFA及TACE RFA组病例总体治疗效果较好。结论:原发性肝癌肝移植围手术期辅助治疗可明显改善肝移植的效果,降低术后的复发率或延长复发时间。

Efficacy of perioperative auxiliary therapy of liver transplantation on primary hepatocellular carcinoma

Objective:To investigate the effect of perioperative auxiliary therapy of liver transplantation on primary hepatocellular carcinoma.Methods:Clinical and following-up date of 36 cases of PHC undertook OLT were analyzed retrospectively.The impact of several styles of periperative assistant therapy,which include simple TACE,TACE PEI,RFA,RFA TACE and systemic chemotherapy on reoccurrence rate and survival rate were compared.Results:The tumor size reduce in 12 cases after perioperative auxiliary therapy with a average of 4.8 1.2cm in diameter,and in 13 cases the clinical tumor stages were decreased.The postoperative reoccurrence rate and survival rate of 1,2,3 year were 33.3%,47.2%,55.6% and 86.1%,77.8%,69.4% respectively.The total therapeutic effect of groups TACE PEI,RFA and TACE RFA were better than those of others.Conclusion:Perioperative auxiliary therapy of liver transplantation on primary hepatocellular carcinoma can improve the total effect and decrease the postoperative reoccurrence rate or delay the time of reoccurrence.