摘要
目的比较不同的手术切缘对肝癌患者术后复发及生存的影响,为肝癌患者手术中选择合理切缘提供参考。方法将152例初治的可手术切除肝癌患者随机分为两组,分别按以下标准手术:74例宽切缘组患者按门静脉血流方向远端距肿瘤边缘2cm,近端距肿瘤边缘1cm完整切除;78例窄切缘组患者切除范围距离肿瘤<1cm,切缘无癌残留。应用KaplanMeier法进行生存分析,用Logrank检验分别比较两组的无瘤生存期和总生存期。结果宽切缘组患者平均无瘤生存期为35.5个月,平均总生存期为42.0个月;窄切缘组患者平均无瘤生存期为28.8个月,平均总生存期为37.5个月,两组无瘤生存期(t=6.01,P=0.0142)和总生存期(t=6.23,P=0.0125)比较,差异均有统计学意义。结论按门静脉血流方向远端距肿瘤2cm,近端距肿瘤1cm切除为标准的手术范围可较合理地延长肝癌患者术后无瘤生存期和总生存期。
Objective To compare the effect of different resection margin in hepatectomy on recurrence and survival of patients with hepatocellular carcinoma （HCC） , and to determine an appropriate resection margin of hepatectomy for HCC patients. Methods 152 untreated HCC patients were randomly divided into two groups based on the distal and proximal resection margin according to direction of the portal vein flow, Seventy-four patients in the wide-margin group had a distal resection margin of 2 cm and a proximal of 1 cm away from the edge of the primary tumor, while 78 patients in the narrow-margin group had a resection margin of 〈 1 cm away from the edge of the primary tumor provided that the margin was proven to be histologically free of cancer cells. The distal and proximal margins were defined. The data were analyzed and compared using Kaplan-Meier survival analysis and Log rank test. Results The mean overall survival time of patients in wide-margin group and narrow-margin group were 42. 0 months and 37. 5 months, respectively. The mean tumor-free survival time of these two groups of patients were 35.5 months and 28.8 months, respectively. Patients in wide-margin group had significantly longer overall survival （t=6.23, P = 0.0125） and tumor-free survival （t = 6.01, P = O. 0142） than patients in the narrow-margin group. Conclusion In hepatectomy for hepatocellular cell carcinoma patients, wide distal resection margin of 2 cm and a proximal of I cm away from the edge of the primary tumors according to direction of the portal vein flow may reasonably improve the overall and tumor-free survival.
出处
《中华肿瘤杂志》
CAS
CSCD
北大核心
2006年第1期47-49,共3页
Chinese Journal of Oncology
关键词
肝细胞癌
外科学
肝切除术
肿瘤复发
生存
Hepatocellular carcinoma/surgery
Hepateetomy
Neoplasm recurrence
Survival value
