不能手术切除原发性肝癌的综合治疗﹙附254例报告﹚

目的:探讨不能手术切除的原发性肝癌有效治疗方法。方法:回顾性总结254例原发性肝癌临床资料、治疗手段及随访资料。结果:231例患者得到随访,随访率91%;62例患者Ⅰ期行肝癌冷冻手术,术后配合综合治疗;192例患者实施以TACE为主的综合治疗,其中,21例获得Ⅱ期手术探查,13例行肝切除术,8例行肝癌冷冻手术。肝癌冷冻患者1、3、5年生存率分别为63.2%、37.1%和25.8%;13例Ⅱ期的肝切除手术患者1、3、5年生存率分别为100%、76.9%、53.8%;以TACE为主综合治疗患者1、3、5年生存率分别为73.4%、27.1%、9.3%;全组患者1、3和5年生存率分别是70.9%、29.5%和13.4%。结论:个体化合理有序的综合治疗可以有效提高不能手术切除的原发性肝癌疗效。

The Comprehensive Therapy for Unresectable Primary Liver Cancer

Objective: To study therapeutic measures of the unresectable primary liver cancer(PLC).Methods: From January 1991 to March 2000,the clinical data of 254 patients with unresectable primary liver cancer were analyzed retrospectively.Results: Seventy patients with unresectable primary liver cancer were treated by cryosurgery combined therapy.One hundredand and ninety-two patients with unresectable primary liver cancer were treated by a TACE oriented comprehensive therapy.Two hundred and thirty-one patients were followed-up from 2 months to 132 months.The 1-,3-and 5-year survival rate in the cryosurgery group were 63.2%,37.1% and 25.8%,respectively.The 1-,3-and 5-year survival rates in the 13 cases with second-stage resection were 100%,76.9% and 53.8%,respectively.The 1-,3-and 5-year survival rates in the TACE group were 73.4%,27.1% and 9.3%,respectively.The overall 1-,3-and 5-year survival rates were 70.9%,29.5% and 13.4%,respectively.Conclusion: Curative effect of unresectable primary liver cancer should be raised by an individual,reasonable and ordered comprehensive therapy.