论文部分内容阅读
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 efficacy of liver transplantation in patients with hepatocellular carcinoma (HCC) complicated with portal vein tumor thrombus (PVTT) and to explore its clinical value. Methods The clinical data and survival of 24 HCC patients with PVTT (transplantation group) undergoing liver transplantation from July 1999 to March 2003 were retrospectively analyzed. Control group were selected the same period of HCC with PVTT routine hepatectomy, portal vein tumor thrombus removal surgery (surgical resection group, 27 cases) and non-surgical treatment (non-surgical group, 59 cases). Results The mortality rate (within 1 month) in the transplantation group was 0. The 6-month, 1-year and 2-year cumulative survival rates were 66.7%, 295% and 236% respectively, which were significantly higher than those in the resection group (P = 0 0 3 6), 42 3%, 2 2 2% and 14 8% (P 0 0 335) and 4 2 1%, 2 4 4% and 4 1% The one-month, one-year and two-year disease-free survival rates were 51.5%, 23.2% and 0 respectively. The overall incidence of extrahepatic or intrahepatic recurrence during follow-up was 66.7%. Conclusions Liver transplantation for patients with HCC complicated with PVTT at this stage is an effective palliative surgery.