论文部分内容阅读
目的 探讨原发性肝癌 (HCC)伴门静脉癌栓 (TTPV )的有效治疗方式。方法 回顾性分析和总结 1995年 1月至 2 0 0 3年 5月期间收治的 95例原发性肝癌伴门静脉癌栓患者的临床资料。结果 5 8例行手术治疗 ,其中 6例行单纯肝肿瘤切除术 ,1、3年生存率为 3 3 .3 %、0 % ;5 2例行肝肿瘤切除加门静脉癌栓取栓术 ,其中 43例术后采用了肝动脉和门静脉双插管微量泵灌注化疗 ,其 1、3、5年生存率为 10 0 %、5 5 .8%、13 .9% ,9例未行插管化疗 ,1、3、5年生存率为 77.7%、2 2 .2 %、0 %。另 3 7例未行手术者中 10例行单纯肝动脉栓塞 (HAE) ,1、3年生存率为 2 0 %、0 % ;2 1例行选择性门静脉栓塞 (SEPV)联合肝动脉栓塞 ,1、3、5年生存率为 71.4%、2 8.6%、9.5 % ;6例未作任何治疗者均 1年内死亡。结论 手术治疗原发性肝癌伴门静脉癌栓有效 ,术后使用肝动脉和门静脉双插管灌注化疗可提高疗效 ,选择性门静脉栓塞联合肝动脉栓塞对不能切除的肝癌伴门静脉癌栓有重要作用
Objective To investigate the effective treatment of primary hepatocellular carcinoma (HCC) with portal vein tumor thrombosis (TTPV). Methods The clinical data of 95 cases of primary liver cancer with portal vein tumor embolus admitted from January 1995 to May 2003 were retrospectively analyzed and summarized. Results 58 cases underwent surgical treatment, of which 6 cases underwent simple hepatic tumor resection. The 1-, 3-year survival rate was 33.3%, 0%; 52 cases were treated with hepatectomy plus portal vein tumor embolectomy. Forty-three patients received hepatic artery and portal vein dual intubation micro-pump infusion chemotherapy. The 1-, 3-, and 5-year survival rates were 100%, 55.8%, and 13.9%. 9 patients were not intubated with chemotherapy. The 1-, 3-, and 5-year survival rates were 77.7%, 22.2%, and 0%. In the other 37 cases without surgery, 10 cases were treated with simple hepatic artery embolization (HAE). The 1-, 3-year survival rates were 20% and 0%; 2 cases underwent selective portal vein embolization (SEPV) combined with hepatic artery embolization. The 1-, 3-, and 5-year survival rates were 71.4%, 28.6%, and 9.5%; 6 patients who did not receive any treatment died within 1 year. Conclusion Surgical treatment of primary hepatocellular carcinoma with portal vein tumor embolus is effective. Postoperative use of hepatic artery and portal vein can improve the efficacy of dual intubation chemotherapy. Selective portal vein embolization combined with hepatic artery embolization plays an important role in unresectable hepatocellular carcinoma with portal vein tumor emboli.