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肝癌合并门静脉癌栓术后门静脉化疗疗效分析
  • ISSN号:1672-3511
  • 期刊名称:《西部医学》
  • 时间:0
  • 分类:R657.3[医药卫生—临床医学;医药卫生—外科学]
  • 作者机构:[1]第四军医大学唐都医院普通外科,陕西西安710038
  • 相关基金:国家自然科学基金(81172287); 陕西省科学技术研究发展计划项目(2014k11-03-03-01)
中文摘要:

目的肝癌合并门静脉癌栓手术切除后,对门静脉化疗疗效进行评估和分析。方法回顾性分析45例合并门静脉癌栓的肝癌病例资料,根据术后治疗情况分为门静脉化疗组(A组)27例,采用手术切除之后辅以门静脉化疗术(PVC)+肝动脉化疗栓塞术(TACE)+微波固化治疗术(PMCT);非门静脉化疗组(B组)18例,采用TACE+PMCT治疗,比较两组疗效及并发症情况。结果围手术期无死亡病例,病理检查均提示为肝细胞癌,45例患者中36例在后期死于肝癌复发转移。两组之间生存率有统计学差异(χ2=3.988 P=0.046)。A组1、3、5年生存率分别是76.0%、40.0%、20.0%,B组分别是55.6%、16.7%、5.6%。术后共实施PMCT39次,TACE136次,比较两组中位数分别为1,1;3,3;平均秩分别为22.52,23.72;20.74,26.39;P分别为0.748,0.141)。结论对可切除的肝癌合并门静脉癌栓实施肝切除术为主,术后辅以PVC+TACE+PMCT疗效更好。

英文摘要:

Objective To evaluate the efficacy of portal vein chemotherapy in patients with liver cancer complicated with portal vein tumor thrombus(PVTT)underwent hepatectomy.Methods Data of 45 cases were retrospectively studied,which were divided into Group PVC and Group Non-PVC according to postoperative further diverse managements.Group PVC(27cases)accepted portal vein chemotherapy(PVC)+transcatheter arterial chemoembolization(TACE)+percutaneous microwave coagulation therapy(PMCT).Group Non-PVC(18cases)was treated with TACE +PMCT.Results All cases were hepatocellular carcinoma(HCC)confirmed by pathological examination without mortality during peri-operation.36 cases died of recurrence and metastasis of HCC forward.There was statistical significance in cumulative survival rate of the two groups(χ2=3.988;P=0.046).1y,3y and 5y survival was 76.0%,40.0% and 20.0%in Group PVC,55.6%,16.7%,5.6% in Group Non-PVC respectively.39 PMCT and 136 TACE of Group PVC and Group Non-PVC were performed after operation.Conclusion PVC+TACE+PMCT can get obvious effect on resectable liver cancer complicated with tumor thombi in portal vein after operation.

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期刊信息
  • 《西部医学》
  • 中国科技核心期刊
  • 主管单位:四川省卫生和计划生育委员会
  • 主办单位:川北医学院第二临床医学院.南充市中心医院
  • 主编:彭海涛
  • 地址:成都市浆洗街8号国嘉南苑10F-6号
  • 邮编:610041
  • 邮箱:xibu@chinajournal.net.cn
  • 电话:028-85570072 85588403
  • 国际标准刊号:ISSN:1672-3511
  • 国内统一刊号:ISSN:51-1654/R
  • 邮发代号:62-243
  • 获奖情况:
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  • 被引量:26154