摘要
目的 评估肝移植治疗肝细胞癌 (HCC)合并门静脉癌栓 (PVTT)病人的临床疗效 ,探讨其临床应用价值。方法 回顾性分析自 1999年 7月至 2 0 0 3年 3月收治的 2 4例施行肝移植的HCC合并PVTT病人 (移植组 )临床资料和生存情况。对照组分别选取同时期HCC合并PVTT行常规肝叶切除、门静脉癌栓取出术者 (手术切除组 ,2 7例 )和非手术治疗者 (未手术组 ,5 9例 )。结果 移植组手术死亡率 (1个月内 )为 0 ;6个月、1年以及 2年累积生存率分别为 6 6 7%、2 9 5 %和 2 3 6 % ,均高于手术切除组的 33 3%、2 2 2 %和 14 8% (P =0 0 335 )和非手术组的 4 2 1%、2 4 4 %和 4 1% (P =0 0 316 ) ;移植组的 6个月、1年和 2年无瘤生存率分别为 5 1 5 %、2 3 2 %和 0 ;随访期间肝外转移或肝内复发的总发生率为 6 6 7%。结论 现阶段HCC合并PVTT病人的肝移植治疗是一种有效的姑息性手术方式。
Objective To evaluate the clinical effects and application value of orthotopic liver transplantation (OLT)for hepatocellular carcinoma (HCC) with portal vein tumor thrombi (PVTT). Methods The clinical and follow-up data of 24 HCC patients with PVTT performed OLT (transplant group) from July 1999 to March 2003 were analyzed retrospectively and compared with those of 27 HCC patients undergone routine hepatic resection (resection group) and 59 HCC patients without surgical treatment (non-surgical group). Results The perioperative mortality (one month) was 0 for transplant group. The 6-month, 1-year, and 2-year cumulative survival rates were 66.7%, 29.5% and 23.6% for transplant group, 33.3%, 22.2% and 14.8% for resection group, (P=0.0335), and 42.1%,24.4%and 4.1% for non-surgical group, respectively (P=0.0316). Patients’ tumor free survival rates at 6-month, 1-year and 2-year were 51.5%, 23.2% and 0 for transplant group, respectively. During follow-up period, the overall posttransplant intrahepatic recurrence or extrahepatic metastasis rate was 66.7% for transplant group. Conclusion OLT is an effective and palliative treatment method for HCC patients with PVTT.
出处
《中国实用外科杂志》
CSCD
北大核心
2004年第9期540-542,共3页
Chinese Journal of Practical Surgery
基金
受国家重点基础研究发展计划资助 ( 973计划
2 0 0 3CB5 15 5 0 1)
关键词
肝移植
治疗
肝细胞癌
合并症
门静脉癌栓
Hepatocellular carcinoma Portal vein tumor thrombi Liver transplantation
