肝切除序贯双管疗法治疗原发性肝癌

 目的　探讨肝癌手术综合治疗及术后复发预防的合理方案。方法　回顾性总结手术治疗316例原发性肝癌，将肝切除的患者分为三组，进行术后无瘤生存率的比较。第一组为单一肝切除组（n＝218），第二组为术前肝动脉化疗栓塞（TACE）+肝切除组（n＝52），第三组为术前TACE+肝切除+术后门静脉化疗组，称为肝切除序贯双管疗法（n＝46）。结果　第一组术后1、3、5年生存率分别为51.2 %、30.0 %和20.5 %，第二组分别为57.2 %、43.0 %、31.5 %，第三组分别为84.0 %、62.5 %和51.0 %。第三组患者与第一组和第二组患者的术后生存率差异均有统计学意义（P＜0.05）。结论　肝切除序贯双管疗法可以提高肝癌患者的生存率，在推迟和预防术后复发方面起到了积极作用。

Hepatectomy sequencing two vessels therapy for primary hepatocellular carcinoma

Objective To summarize the experience of adjuvant therapy for primary hepatocellular carcinoma. Methods 316 cases of operable hepatocellular carcinoma were divided into three groups. Only hepatectomy were performed in group one (21 8cases).Preopemtive adjuvant TACE were done in group two (52 cases). Preoperative adjuvant TACE and postoperative trans-portal vein chemotherapy were done in group three (46 cases), which was named hepatectomy sequencing two vessel therapy. Results 1, 3 and 5 year survival rote were 51.2 %, 30.0 % and 20.5 % respectively in group one, 57.2 %, 43.0 % and 31.5 % in group two, 84.0 %, 62.5 % and 51.0 % in group three. The postoperative disease-free survival rate in group three was significantly higher than that in group one and group two (P ＜0.05). Conclusion Hepatectomy sequencing two vessels therapy in perioperative period might improve the survival rate, which can prevent and delay the incidence of recurrence and may improve the effect of liver resection.