门静脉化疗对合并癌栓的原发性肝癌术后复发的预防作用

目的　探讨门静脉导管保留术并根据体外肿瘤药敏试验定期行门静脉化疗对合并门静脉癌栓的原发性肝癌术后复发的预防作用。方法　术前经B型超声或CT证实有门静脉癌栓的原发性肝癌病人 6 2例随机分成对照组 (2 9例 )和治疗组 (33例 )。治疗组在肝癌联同门脉癌栓切除术中常规行门静导管保留术 ,术后根据体外肿瘤药物敏感性试验选用敏感性化疗药物定期行门静脉化疗。对照组在肝癌及门静脉癌栓切除术后未行特殊治疗。结果　对照组与治疗组术后半年、1年复发率分别为 1 4例 (4 8.3% )、2 2例 (75 .9% )和 9例 (2 7.3% )、1 6例 (4 8.5 % ) ;两组术后半年、1年死亡率分别为 1 1例 (37.9% )、1 9例 (6 5 .5 % )与 6例 (1 8.2 % )、1 2例 (36 .4 % )。两组比较均有显著性差异 (P <0 .0 5 )。结论　肝细胞肝癌伴门静脉癌栓行手术切除有较好的疗效。而术后根据药物敏感性试验通过门静脉化疗可明显降低术后复发率 ,延长生存期

Prophylaxis of portal vein chemotherapy on the recurrence after resection of hepatocellular carcinoma with tumor thrombi in portal vein

Objective To explore the prophylaxis of portal vein chemotherapy on the recurrence after resection of hepatocellular carcinoma(HCC)with tumor thrombi in portal vein (PVTT).Methods Sixty two cases of HCC with PVTT confirmed by B ultrasound or CT preoperatively were divided into two groups:treatment group(33 cases)with a pipe reserved when resection of HCC with PVTT,periodical chemotherapy in portal vein pipe according to in vitro drug sensitivity test after operation;control group(29 cases)with nothing to do after operation.Results The 0.5 and one year recurrent rate was 27.3% and 48.5% in treatment group,and 48.3% and 75.9% in control group respectively.The 0.5 and one year mortality was 18.2% and 36.4% in treatment group,and 37.9% and 65.5% in control group respectively.There was significant difference between two groups ( P < 0.05 ).Conclusion Resection has a satisfactory effect in HCC with PVTT.Portal vein chemotherapy according to in vitro drug sensitivity test can reduce the recurrent rate after operation and prolong the survival time.