巴塞罗那C期巨大肝癌成功转化治疗后行根治性切除一例  

Successful conversion therapy and radical resection for huge Barcelona Clinic Liver Cancer stage C hepatocellular carcinoma:A case report

作　　者：严翔 郑伟[1] 陈思攀[2] 张智勇[1] 杜立学[1] Xiang Yan;Wei Zheng;Si-Pan Chen;Zhi-Yong Zhang;Li-Xue Du(Department of Hepatobiliary Surgery,Shaanxi Provincial People’s Hospital,Xi’an 710068,Shaanxi Province,China)

机构地区：[1]陕西省人民医院肝胆外科,陕西省西安市710068 [2]陕西省人民医院介入放射科,陕西省西安市710068

出　　处：《世界华人消化杂志》2022年第3期164-168,共5页World Chinese Journal of Digestology

摘　　要：背景原发性肝癌(hepatocellular carcinoma,HCC)患者初诊时大都已进展为中晚期,失去最佳手术时机,而且术后复发率高,预后差.随着近年来全身治疗的发展,对于初诊不可切除的患者先行转化治疗可改变围手术期患者的诊疗方式.本文报道1例初诊时累及门静脉右支的巨大肝癌经过术前转化治疗后行根治性右半肝切除术.病例简介本例患者以“间断性右上腹隐痛2月余”之主诉于入院.初诊时考虑原发性肝癌进展为巴塞罗那临床肝癌(Barcelona Clinic Liver Cancer,BCLC)C期(BCLC-C),既往合并乙肝及肝硬化病史,未接受系统抗病毒治疗,肿瘤为巨块型(肿瘤直径超过10 cm),门静脉右支闭塞,左支癌栓形成,已失去手术机会,单一治疗效果有限.结论对于中晚期肝癌患者,转化治疗将给他们带来根治希望.尤其是初始不可切除的患者,系统治疗将逐步在肝癌的治疗体系中起到更为重要的作用.BACKGROUND Conversion therapy play a key role in the treatment of Barcelona Clinic Liver Cancer stage C(BCLC-C)hepatocellular carcinoma.CASE SUMMARY We report a patient with BCLC-C hepatocellular carcinoma who underwent conversion therapy.Radical resection was executed consecutively after portal vein tumor thrombus regression.CONCLUSION Conversion therapy may provide an opportunity for curative therapy in patients with advanced hepatocellular carcinoma.More attention should be paid to systemic therapy in patients with initially unresectable tumors.

关 键 词：原发性肝癌 转化治疗 肝切除术 介入治疗 多学科协作组 

分 类 号：R735.7[医药卫生—肿瘤]