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首页> 外文期刊>ANZ journal of surgery >Cytoreductive surgery in multidisciplinary treatment of advanced hepatocellular carcinoma.
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Cytoreductive surgery in multidisciplinary treatment of advanced hepatocellular carcinoma.

机译：细胞减少手术在多学科治疗晚期肝细胞癌中的应用。

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BACKGROUND: Cytoreductive surgery (debulking surgery) as a multidisciplinary treatment approach for inoperable advanced hepatocellular carcinoma has been shown to prolong survival and provide symptomatic relief for good surgical risks patients in non-randomized studies before. METHODS: A non-randomized comparative study was performed in a tertiary referral centre between January 2001 and December 2006. The outcome of a consecutive series of patients with inoperable advanced hepatocellular carcinoma who received cytoreductive surgery was compared with a control group of patients who received palliative treatment without surgery. Two techniques of cytoreductive surgery were used: (i) partial hepatectomy for the main tumour plus intraoperative local ablative therapy for the smaller tumour nodules in the liver remnant; and (ii) partial hepatectomy for the main tumour plus postoperative transarterial chemoembolization. RESULTS: The overall survival of cytoreductive surgery group (n = 18) was significantly better than that of the palliative treatment group (n = 15) (3-year overall survival, 54% vs 22%; median survival, 18 vs 11 months) (P =0.038). In the cytoreductive surgery group, there was no operative mortality. Postoperative morbidity rate was 16.7%. The mean hospital stay was 8 days. CONCLUSION: Cytoreductive treatment strategy for advanced hepatocellular carcinoma can be considered as one of the options in selected patients with low operative risks and reasonable liver function. Further prospective randomized trials are required to validate this aggressive surgical approach.
机译：背景：在以前的非随机研究中，细胞减少手术（体减术）作为无法手术的晚期肝细胞癌的多学科治疗方法已被证明可以延长生存期，并为良好的手术风险患者提供症状缓解。方法：2001年1月至2006年12月间在三级转诊中心进行了非随机比较研究。将连续进行的一系列不能接受手术的晚期肝细胞癌患者接受细胞减灭术的结果与对照组接受姑息治疗的患者的结果进行了比较。无手术治疗。使用了两种细胞减灭术技术：（i）对主要肿瘤进行部分肝切除术，对肝脏残余物中较小的肿瘤结节进行术中局部消融治疗; （ii）对主要肿瘤加部分肝切除术以及术后经动脉化学栓塞治疗。结果：细胞减灭术组的总生存期（n = 18）明显优于姑息治疗组（n = 15）（3年总生存期54％vs 22％;中位生存期18 vs 11个月） （P ＝ 0.038）。在减细胞手术组中，没有手术死亡率。术后发病率为16.7％。平均住院时间为8天。结论：对于一些手术风险低，肝功能合理的患者，晚期肝细胞癌的减细胞治疗策略可以作为选择之一。需要进一步的前瞻性随机试验来验证这种积极的手术方法。

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