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目的比较Child A级、单个、直径≤5 cm肝细胞肝癌行肝移植与肝切除术的预后。方法回顾性分析笔者所在医院肝移植中心2007~2011年期间行肝切除术及肝移植术的Child A级、单个、直径≤5 cm肝细胞肝癌患者的临床资料,比较2组患者术后无瘤生存率及总体生存率。结果本研究共纳入263例患者,其中肝移植组36例,肝切除组227例。肝移植组与肝切除组患者术后1、3及5年无瘤生存率分别为91.7%、85.3%及81.0%和80.6%、59.8%及50.8%,肝移植组高于肝切除组(P=0.003);术后1、3及5年总体生存率分别为100%、87.5%及83.1%和96.9%、83.8%及76.1%,2组间差异无统计学意义(P=0.391)。以肿瘤直径<3 cm为标准再予以分析,其肝移植组与肝切除组术后1、3及5年无瘤生存率分别为92.3%、92.3%及92.3%和80.2%、62.5%及50.5%,肝移植组高于肝切除组(P=0.019);术后1、3及5年总体生存率分别为100%、91.7%及91.7%和97.7%、87.5%及79.5%,2组间差异也无统计学意义(P=0.470)。结论 Child A级、单个、直径≤5 cm肝细胞肝癌患者肝切除术后复发率高于肝移植,但两种治疗方式的术后总体生存率相似。
Objective To compare the prognosis of Child A grading, single liver transplantation and hepatectomy with single diameter ≤5 cm hepatocellular carcinoma. Methods The clinical data of Child A grade, single, diameter ≤5 cm hepatocellular carcinoma patients undergoing liver resection and liver transplantation from 2007 to 2011 in our hospital liver transplant center were retrospectively analyzed. No tumor was found in the two groups Survival and overall survival. Results A total of 263 patients were enrolled in this study, including 36 in the liver transplantation group and 227 in the hepatectomy group. The 1,3 and 5 year postoperative tumor free survival rates were 91.7%, 85.3%, 81.0% and 80.6%, 59.8% and 50.8% in the liver transplantation group and the hepatectomy group, respectively, and were significantly higher in the liver transplantation group than in the hepatectomy group = 0.003). The overall survival rates at 1, 3 and 5 years after surgery were 100%, 87.5% and 83.1% and 96.9%, 83.8% and 76.1% respectively. There was no significant difference between the two groups (P = 0.391). The tumor-free survival rates at 1, 3, and 5 years after operation were 92.3%, 92.3%, 92.3%, 80.2%, 62.5%, and 50.5 (P = 0.019). The overall 1,3 and 5 year survival rates were 100%, 91.7%, 91.7% and 97.7%, 87.5% and 79.5% respectively in the two groups The difference was not statistically significant (P = 0.470). Conclusions Child A-class, single, hepatocellular carcinoma with a diameter less than 5 cm has a higher recurrence rate after liver resection than the liver transplantation, but the overall survival after the two treatment methods is similar.