局解手术学杂志2016，Vol.25Issue(6)：409-412,4.DOI:10.11659/jjssx.03E016097
补救性肝移植和再次肝切除治疗肝癌术后复发的疗效对比
Comparative effect of salvage liver transplantation and repeated hepatectomy for recurrent hepatocellular carcinoma
摘要
Abstract
Objective To evaluate the curative effect of salvage liver transplantation and repeated hepatectomy for recurrent hepatocel-lular carcinoma.Methods The data of 72 patients with recurrent hepatocellular carcinoma fulfilling Child-Pugh A and the Milan criteria from September 2004 to August 2010 were retrospectively studied.According to different treatments,53 patients were divided into repeated hepatec-tomy group,and 19 patients were divided into salvage liver transplantation group.The overall survival rates and disease-free survival rates after operation were evaluated by Kaplan-Meier method.COX proportional hazard was used for univariate analysis and multivariate analysis to eval-uate the risk factors for prognosis.Results The 1-year,3-year and 5-year survival rates were 86.79%,62.26% and 45.28% in repeated hepatectomy group,and 89.47%,68.42%and 57.89% in the salvage liver transplantation group respectively.There was no significant differ-ence in the overall survival rates between the two groups (χ2 =2.530,P =0.112).The 1-year,3-year and 5-year disease-free survival rates were 67.92%,47.17% and 35.85%in the repeated hepatectomy group,94.74%,68.42% and 52.63% in the salvage liver transplantation group respectively.There was a significant difference in the disease-free survival rates between the two groups(χ2 =4.395,P =0.036).The univariate analysis and multivariate analysis indicated that microvascular invasion,satellite lesion and multiple tumors were the independent risk factors to influence the survival.Conclusion The salvage liver transplantation obtains a better effect for the patients fulfilling Child-Pugh A and the Milan criteria,which is an effective method in the treatment of hepatocellular carcinoma.关键词
肝癌/复发/再次肝切除/补救性肝移植/米兰标准Key words
hepatocellular carcinoma/recurrence/repeated hepatectomy/salvage liver transplantation/Milan criteria分类
医药卫生引用本文复制引用
杜苏明,张小进,江艺..补救性肝移植和再次肝切除治疗肝癌术后复发的疗效对比[J].局解手术学杂志,2016,25(6):409-412,4.基金项目
2015年福建省重点项目 （）
