论文部分内容阅读
本文对37例中晚期肝癌经股动脉化疗栓塞(THAE)后二期切除的效果进行分析。THAE治疗后1～2个月,瘤体直径中位数由14cm缩为7.9cm,缩小30%～88.8%。行规则性肝段或局部切除共29例(占78.38%),半肝切除8例(占21.62%)。手术死亡率2.7%,术后6个月、1年、2年、生存率(生命表法)分别为97.30%,89.10%、80.62%。术后病理切片中有癌细胞残留者占86.48%(32/37)。我们初步认为THAE是目前对中晚期肝癌治疗的好方法。但不失时机地二期切除能使部分病人得到根治的机会。因此,二期切除在临床上不仅有其必要性,而且对提高整体肝癌预后具有重大作用。二期切除的时机以栓塞后1～3个月为宜,本组91.89%(34/37)于栓塞后2个月内切除。
This article analyzes the effect of second-stage resection of 37 cases of advanced liver cancer after femoral chemoembolization (THAE). One to two months after THAE treatment, the median diameter of the tumor was reduced from 14cm to 7.9cm, which was reduced by 30% to 88.8%. A total of 29 cases (78.38%) were undergone regular liver resection or local resection, and 8 cases (21.62%) were hemihepatectomy. The operative mortality rate was 2.7%. At 6 months, 1 year, and 2 years after surgery, the survival rate (life table method) was 97.30%, 89.10%, and 80.62%, respectively. There were 86.48% (32/37) of cancerous residuals in pathological sections. We tentatively believe that THAE is currently a good method for the treatment of advanced liver cancer. However, two-stage resection without losing the opportunity can make some patients get the opportunity to cure. Therefore, second-phase resection is not only necessary in clinical practice, but also has a significant role in improving the overall prognosis of liver cancer. The timing of the second-stage resection is preferably 1 to 3 months after embolization. 91.89% (34/37) of this group were removed within 2 months after embolization.