摘要
目的通过对肝细胞肝癌(HCC)切除术后复发并再次手术病例临床资料的回顾性分析,探讨HCC术后复发时间对再次手术预后的影响。方法 2005年1月至2010年1月,我中心收治HCC术后复发并再次施行肝切除手术共25例,全部病例再次手术前均通过影像学检查明确为肝内复发并除外肝外转移,术后通过数字减影血管成像技术(DSA)进行随诊;再次手术术后随访时间均超过12个月。结果根据首次手术术后复发时间分为两组,术后12个月内复发17例,再次手术后12个月内再次复发16例,复发率94.1%;术后复发时间超过12个月病例8例,再次手术后12个月内再次复发2例,复发率25.0%,两组首次手术后无病生存时间、复发后生存时间和总生存时间均有统计学差异(χ2=11.091,P=0.001;χ2=4.864,P=0.027;χ2=9.694,P=0.002);再次手术时12个月内复发组平均年龄明显小于12个月以上复发组[(48.5±10.0)岁vs.(55.6±8.2)岁,t=-2.416,P=0.019]。结论 HCC术后早期复发提示再次手术预后不佳,复发率高,12个月内复发病例特别是年轻病例不宜过早进行再次手术;复发时间超过12个月的HCC病例再次手术后1年复发率较低、预后好,应采取积极治疗。
Objective To investigate the influence of the hepatocellular carcinoma(HCC)postoperative recurrence time to the prognosis of the reoperation.Methods From Jan 2005 to Jan 2010,25 patients who underwent curative resection for HCC were followed for intrahepatic recurrence,which was treated by the reoperation.Survival results after recurrence and from initial hepatectomy were analyzed by Kaplan-Meier analysis.All the cases were clear for intrahepatic recurrence and expect for extrahepatic metastasis by imaging examination before the reoperation.Follow-up were conducted by digital subtraction angiography(DSA)after surgery.The patients were followed up over 12 months after the reoperation.Results All patients were divided into two groups based on the first postoperative recurrence time.Seventeen patients were recurrence within 12 months,and 16 patients were recurrence again within 12 months after the reoperation while the recurrence rate was 94.1%.Twelve patients were recurrence over 12 months and 2 of them were recurrence again within 12 months after the reoperation,while the recurrence rate was 25%.Diseases-free survival time,after recurrence survival time and overall survival time of two groups had significant difference(χ2=11.091,P=0.001;χ2=4.864,P=0.027;χ2=9.694,P=0.002).The average age of recurrence within 12 months group were significant less than that of recurrence over 12 months group(48.5±10.0 vs.55.6±8.2,t=-2.416,P=0.019).Conclusions Early postoperative recurrence hints the poor prognosis of reoperation and high recurrence rate.The patients who were recurrence within 12 months,especially young cases,could not reoperation early.The HCC patients who were recurrence over 12 months should take active treatment because of the lower one year recurrence rate and better prognosis.
出处
《中华临床医师杂志（电子版）》
CAS
2012年第20期61-64,共4页
Chinese Journal of Clinicians(Electronic Edition)
关键词
癌
肝细胞
肝切除术
复发
Carcinoma,hepatocellular
Hepatectomy
Recurrence
