单中心831例原发性肝癌个体化综合外科治疗的远期疗效  

Long-term treatment outcomes of 831 patients with primary hepatic carcinoma who received person- alized integrated surgical therapy in a single-institution

作　　者：孔德刚[1] 卢实春[1] 王孟龙[1] 林栋栋[1] 郭庆良[1] 武聚山[1] 曾道炳[1] 刘源[1] 张毅[1] 高大明[1] 张静[1] 李宁[1] 

机构地区：[1]首都医科大学附属北京佑安医院普外中心,北京100069

出　　处：《中华肝胆外科杂志》2014年第6期410-413,共4页Chinese Journal of Hepatobiliary Surgery

基　　金：国家科技支持计划（2012BAl06801）;北京市卫生系统高层次卫生技术人才培养计划（2011-2-18）

摘　　要：目的探讨个体化综合外科治疗模式下原发性肝癌的远期临床疗效。方法回顾性分析首都医科大学附属北京佑安医院普外中心2004年3月至2013年9月831例原发性肝癌患者的临床资料。按不同肿瘤分期、病理类型及治疗方式分组，分别计算术后总体生存率和无瘤生存率，并比较分析组间差异。结果术后获得随访的患者796例，其总体1、3、5年生存率分别为88．6％、71．7％、61．3％，无瘤生存率分别为69．6％，47．9％，38．4％。其中，742例肝细胞癌（HCC）患者1、3、5年生存率为89，6％、73．2％、63．2％；无瘤生存率为72．1％，52．5％，45．5％。全部患者三种治疗方式生存曲线比较：肝移植（LT）组与肝切除组生存期优于射频消融（RFA）组，LT组在60个月后显示出明显生存优势。结论个体化综合外科治疗模式可以使原发性肝癌的整体治疗疗效得到进一步提高。Objective To investigate the long-term outcomes of patients with primary hepatic carcinoma （PHC） who received personalized integrated surgical therapy. Methods The clinical data of 831 patients with PHC treated at the General Surgery Department of the Capital Medical University Affiliated Beijing Youan Hospital between March 2004 and September 2013 were retrospectively analyzed. The patients were grouped according to tumor staging, pathology and type of operation. The overall survival and tumor free survival rates were calculated and the survival rates in the different groups were compared. Results Of the 796 patients with PHC who received regular follow-up, the 1-,3-,5-year overall survival and tumor free survival rates were 88.6% , 71.7% , 61.3% and 69.6% , 47.9% , 38.4% respectively. For the 742 patients with hepatocellular carcinoma, the 1-, 3-, 5-year overall survival and tumor free survival rates were 89. 6%, 73.2%, 63.2% and 72. 1% , 52. 5%, 45.5% respectively. The liver transplantation （LT） group and the liver resection group had better survival than the radio frequency ablation （RFA） group. The LT group had significantly better survival after 60 months of surgery than the liver resection group. Conclusion The personalized integrated surgical therapeutic model improved the therapeutic efficacy.

关 键 词：原发性肝癌 个体化综合治疗模式 远期疗效 

分 类 号：R735.7[医药卫生—肿瘤]