中华医学杂志（英文版）2012，Vol.125Issue(2)：197-202,6.DOI:10.3760/cma.j.issn.0366-6999.2012.02.007
Effect of resection following downstaging of unresectable hepatocelluar carcinoma by transcatheter arterial chemoembolization
Effect of resection following downstaging of unresectable hepatocelluar carcinoma by transcatheter arterial chemoembolization
SHI Xian-jie 1JIN Xin 1WANG Mao-qiang 2WEI Li-xin 3YE Hui-yi 4LIANG Yu-rong 1LUO Ying 1DONG Jia-hong1
作者信息
- 1. Department of Hepatobillary Surgery, General Hospital of Chinese People's Liberation Army, Beijing 100853, China
- 2. Department of Intervention Radiology, General Hospital of Chinese People's Liberation Army, Beijing 100853, China
- 3. Department of Pathology, General Hospital of Chinese People's Liberation Army, Beijing 100853, China
- 4. Department of Radiology, General Hospital of Chinese People's Liberation Army, Beijing 100853, China
- 折叠
摘要
Abstract
Background This retrospective study was undertaken to analyze the outcome of hepatic resection in fifty-two patients with unresectable hepatocellular carcinoma (HCC) between January 2004 and December 2008.Methods Among these fifty-two patients,the mean diameter of the tumor was 7.9 cm (4.4-15.5 cm,median 8.5 cm) prior to the first transcatheter arterial chemoembolization (TACE).After 1-6 times of TACE (median 2),the median tumor diameter was reduced to 4.2 cm (0-8.4 cm) prior to resection.The duration between the last TACE treatment and sequential resection varied from one to six months (median 2.7 months).Serum α-fetoprotein (AFP) levels were abnormal in thirty-eight out of the fifty-two patients.In AFP producing HCCs,AFP levels returned to normal (≤400 μg/L) in twenty-five out of thirty-eight patients.Hepatic segmentectomy,multiple hepatic segmentectomy or partial hepatic resection were performed in forty-five patients,two underwent extended left hemihepatectomy,and one underwent right posterior branch portal vein thrombectomy.One patient received a right hemihepatectomy and three had left hemihepatectomies.Results Complete tumor radiological response (CR) occurred in five patients (9.6％).There were three cases of perioperative mortality in the fifty-two patients (5.8％).One patient underwent salvaged orthotopic liver transplantation,and twenty-one patients observed tumor recurrence within two years.The 1-,3- and 5-year survival rates of the fifty-two patients were 77.0％ (n=40),55.0％ (n=29),and 52.0％ (n=28),respectively.The median survival time after surgery was 49 months (95％ confidence interval 7.5-52.7 months).Conclusions TACE treatment provides a better chance for HCC resection in patients initially diagnosed with unresectable HCC.Furthermore,liver resection should be performed once the tumor is downstaged to be compatible for successful resection关键词
hepatocellular carcinoma/tumor downstaging/transcatheter arterial chemoembolization/hepatectomyKey words
hepatocellular carcinoma/tumor downstaging/transcatheter arterial chemoembolization/hepatectomy引用本文复制引用
SHI Xian-jie,JIN Xin,WANG Mao-qiang,WEI Li-xin,YE Hui-yi,LIANG Yu-rong,LUO Ying,DONG Jia-hong..Effect of resection following downstaging of unresectable hepatocelluar carcinoma by transcatheter arterial chemoembolization[J].中华医学杂志（英文版）,2012,125(2):197-202,6.
