肿瘤的解剖学分布对符合Milan标准的多个肝癌切除术后疗效的影响  

The Effect of Anatomical Distribution of Multiple Tumors for HCC Patients Meeting The Milan Criteria after Hepatic Resection

作　　者：沈舒[1] 章蔚[1] 吕涛[1] 蒋利[1] 杨家印[1] 严律南[1] 李波[1] 文天夫[1] 

机构地区：[1]四川大学华西医院肝脏外科,四川成都610041

出　　处：《中国普外基础与临床杂志》2015年第10期1164-1167,共4页Chinese Journal of Bases and Clinics In General Surgery

基　　金：国家自然科学基金(项目编号:81400636);四川省科技支撑计划项目(项目编号:2013SZ0023)~~

摘　　要：目的比较符合米兰标准的多发肝癌位于相同和不同肝区在切除术后的近期和远期效果。方法按照肿瘤的解剖学分布(Couinaud分段法),共有219例符合米兰标准的多发性肝癌患者纳入研究,并分为多灶同区组(n=97,肿瘤均位于同一肝区)和多灶不同区组(n=122,肿瘤位于不同肝区)。对其临床资料进行回顾性分析。结果多灶同区组患者术后1、3和5年的累积总体生存率(overall survival,OS)和无瘤生存率(recurrence-free survival,RFS)均明显高于多灶不同区组(P<0.05)。亚组分析结果显示:2个肿瘤组与整块切除组术后的累积OS和RFS更高(P<0.05)。结论对于符合米兰标准的多病灶肝癌患者,相比那些肿瘤位于不同肝区的患者而言,肿瘤位于同一肝区者在手术切除后有着更好的长期生存和更低的肿瘤复发。Objective To exclusively compare the short- and long-term outcomes of hepatic resection （HR） patients with multifocal tumors meeting the Milan criteria between locating in same and different sections. Methods A total of 219 consecutive HR patients with multifocal tumors meeting the Milan criteria were divided into group SS （n=97, same section） and group DS （n= 122, different sections） according to their anatomical location （Coninaud＇s segmentation）. Results The 1-, 3-, and 5-year overall survival （OS） and recurrence-free survival （RFS） rates were significantly higher in the group SS than those in the group DS （P〈0,05）. The subgroup analysis showed that patients with 2 tumors and those undergoing en bloc resection were associated with better OS and RFS （P〈0.05）. Conclusions For HCC patients with multifocal tumors meeting the Milan criteria, those with tumors locating in same hepatic section may have better long- term survival and lower HCC recurrence rates than those locating in different sections after HR.

关 键 词：多个肿瘤 肝细胞癌 解剖学分布 米兰标准 肝切除 

分 类 号：R735.7[医药卫生—肿瘤]