J CANCER RES CLIN:部分进展期肝癌仍可手术
2012-11-29 J CANCER RES CLIN J CANCER RES CLIN
上海第二军医大学东方肝胆外科医院杨田等近期发表的一项回顾性分析表明,根据国际认可的巴塞罗那分期(BCLC)判断为进展期(C 期)的肝细胞癌患者,在肿瘤可切除、肝功能储备良好和剩余肝体积足够的情况下,仍可考虑外科手术治疗。 该研究纳入了2001-2007 年收治的511 例判定为BC
Surgical resection for advanced hepatocellular carcinoma according to Barcelona Clinic Liver Cancer (BCLC) staging
Purpose
The BCLC staging classification has been widely endorsed to predict the prognosis of patients with HCC. However, its validity as a means of therapeutic instructions needs to be challenged. This study aimed to evaluate perioperative and long-term outcomes of surgical resection in patients with advanced hepatocellular carcinoma (HCC) according to the Barcelona Clinic Liver Cancer (BCLC) staging.
Methods
This study used a prospectively maintained database consisting of a consecutive series of 511 Chinese patients with advanced HCC who underwent surgical resection in a hepatobiliary surgical center from 2001 to 2007. Mortality, morbidity, long-term overall survival (OS) and disease-free survival (DFS) were evaluated.
Results
Hospital mortality was 2.3%, and overall morbidity was 31.3%. After a median follow-up period of 27.8 months (range, 0–112 months), the 1-, 3- and 5-year OS rate was 69.9, 41.2 and 30.5%, and the 1-, 3- and 5-year DFS rate was 48.2, 30.3 and 24.0%, respectively. The 1-, 3- and 5-year OS and DFS rates were significantly poorer in patients with vascular invasion and/or extrahepatic spread than those in patients without (both P < 0.001), and also poorer in patients with biliary invasion than those in patients without (both P < 0.05).
Conclusions
Surgical resection could be considered in part of patients with advanced HCC (BCLC stage C), with low mortality, acceptable morbidity and favorable survival benefits. These results imply that BCLC recommendations for treatment schedules of advanced HCC need to be re-evaluated.
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#进展期#
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