肝切除联合术中热消融治疗肝硬化背景下多灶性肝癌

目的探讨肝切除联合术中热消融治疗肝硬化背景下多灶性肝癌的有效性和安全性。方法回顾性分析63例接受肝切除联合术中热消融治疗肝硬化背景下多灶性肝癌患者的临床资料,分析患者的治疗效果及并发症。结果 63例患者共切除病灶85个,病灶平均最大直径(4.66±3.82)cm,热消融治疗病灶146个,病灶平均最大直径(1.48±0.66)cm。146个病灶完全消融率达100%(146/146),局部复发率4.11%(6/146)。患者1、2、3、4年无瘤生存率分别为54.82%、31.28%、12.03%、6.02%;1、3、5年累积生存率分别为83.51%、56.83%、45.20%。未出现治疗相关的死亡病例。肝切除相关严重并发症8例(8/63,12.70%)。未出现热消融相关严重并发症。结论肝切除联合术中热消融治疗肝硬化背景下多灶性肝癌安全、有效,扩大了肝切除术的适应证。

Hepatic resection combined with intraoperative thermal ablation for multifocal primary liver cancer in patients with cirrhosis

Objective To explore the efficacy and safety of hepatic resection combined with intraoperative thermal ablation for multifocal primary liver cancer in patients with cirrhosis. Methods Clinical data of 63 patients diagnosed multifocal primary liver cancer with cirrhosis and treated with hepatic resection combined with intraoperative thermal ablation was reviewed retrospectively. The therapeutic effect and complications of patients were analyzed. Results Eighty-five lesions were excised in 63 patients, and the average largest diameter was (4.66±3.82)cm. One hundred and forty-six lesions were ablated in all patients, and the average largest diameter was (1.48±0.66)cm. The complete ablation rate and local recurrence rate of ablated lesions were 100% (146/146) and 4.11% (6/146). Disease-free survival rates at 1, 2, 3, and 4 years were 54.82%, 31.28%, 12.03%, 6.02%, respectively. Cumulative survival rates at 1, 3, and 5 years were 83.51%, 56.83%, 45.20%, respectively. There was no patient deaths due to treatment. Major complications hepatectomy-related occurred in 8 cases (8/63, 12.70%). There was no major complications ablation-related. Conclusion Hepatic resection combined with intraoperative thermal ablation is an effective and safe treatment modality for multifocal primary liver cancer in patients with cirrhosis. The technique can widen the indications of hepatectomy.