Objective To compare the effect of two chemotherapeutic patterns after hepatectomy of hepatocellular carcinoma (HCC) with portal vein tumor thrombi(PVTT).
Methods The clinical data of 51 HCC patients with PVTT who were treated in our department from June 2006 to December 2011 were analyzed retrospectively. Fifty-one HCC patients with PVTT who were performed hepatectomy and treatment of antivirus and improve immune were divided into two groups according to chemotherapeutic patterns after operation: portal vein infusion drug deliver system (PVIDDS)group (n=19) and transcatheter arterial chemoembolization(TACE) group(n=32),and to compare the treatment effect of the two groups.
Results The recurrence rate of 1-month, 1-year,3-year, and 5-year after operation in TACE group was 3.1%(1/32),46.9%(15/32),84.4%(27/32), and 100%(32/32),respectively. And in PVIDDS group, which was 5.3%(1/19),52.6%(10/19),100%(19/19), and 100%(19/19),respectively. There were no differences in recurrence rate of 1-month, 1-year, and 5-year after operation in two groups(P>0.05). Recurrence rate of 3-year after operation in TACE group was lower than that in PVIDDS group(P<0.05). There were no differences in medial survival time(17.1 months vs.15.9 months), survival rate of 1-year(93.8% vs.94.7%) and 3-year(40.6% vs. 36.8%) after operation in TACE group and PVIDDS group(P>0.05). Survival rate of 5-year after operation in TACE group was higher than that in PVIDDS group(21.9% vs.0, P<0.05). The rate of complication in TACE group was lower than that in PVIDDS group(65.6% vs.94.7%,P<0.05).
Conclusions If the HCC patients with PVTT could endure operation,surgical resection should be considered firstly,furthermore antivirus treatment, improving immune,and chemotherapy should be considered after operation. The effect of TACE is better than PVIDDS.
Citation:
CHEN Zheyu,LU Wusheng,YAN Lnan,.. Compare The Effects of Two Chemotherapeutic Patterns after Hepatectomy of Hepatocellular Carcinoma with Portal Vein Tumor Thrombus. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2012, 19(3): 252-255. doi:
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樊嘉, 黄成. 肝癌门静脉癌栓的外科治疗 [J]. 中国普外基础与临床杂志, 2004, 11(5):380-382.
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樊嘉, 吴志全, 周俭. 肝细胞癌伴门静脉癌栓不同治疗方法的比较 [J]. 中华肿瘤杂志, 2000, 22(3):247-249.
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程树群, 吴孟超. 肝癌门静脉癌栓临床研究进展和展望 [J].中国微创外科杂志, 2007,7(1):6-7.
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4. |
王晓颖, 樊嘉. 肝癌合并门静脉癌栓的治疗方法及价值 [J].肝胆外科杂志, 2009, 17(1):9-11.
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5. |
严律南, 陈晓理, 李志辉, 等. 肝癌肝切除术围手术期处理的临床研究( 附2 143 例报告) [J]. 中国普外基础与临床杂志,2005,12(2):162-166.
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6. |
文天夫, 严律南. 肝切除术中肝脏血流阻断技术的研究进展 [J]. 中国普外基础与临床杂志, 2008, 15(4):299-302.
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7. |
柴天桥, 靳曙光, 陈哲宇. 复杂巨大肝肿瘤的精确切除体会 [J]. 中国普外基础与临床杂志, 2011,18(9):952-955.
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8. |
吴孟超. 原发性肝癌伴门静脉癌栓的外科治疗 [J]. 中华医学杂志, 2004, 84(1):1-2.
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9. |
胡文杰, 梁力建, 周奇, 等. 化疗联合免疫治疗在提高肝癌合并门静脉癌栓术后疗效中的作用 [J]. 中华外科杂志, 2007,45(19):1325-1327.
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10. |
Timothy MP, Ronnie TP, Abdalla EK, et al. Hepatectomy for hepatocellular carcinoma with major portal or hepatic vein invasion:results of a multicenter study [J]. Surgery, 2005,137(4):403-410.
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11. |
刘宇斌, 简志祥, 区金锐, 等. 原发性肝癌合并门静脉癌栓的外科治疗方式选择 [J]. 中华外科杂志, 2005, 43(7):436-438.
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12. |
程树群, 吴孟超, 陈汉, 等. 癌栓分型对肝细胞性肝癌合并门静脉癌栓治疗和预后的指导意义 [J]. 中华医学杂志, 2004,84(1):3-5.
|
13. |
Ando E, Tanaka M, Yamashita F, et al. Hepatic arterial infusion chemotherapy for advanced hepatocellular carcinoma with portal vein tumor thrombosis: analysis of 48 cases [J]. Cancer, 2002,95(3):588-595.
|
14. |
Le Treut YP, Hardwigsen J, Ananian P, et al. Resection of hepatocellular carcinoma with tumor thrombus in the major vasculature. A European case-control series [J]. J Gastrointest Surg, 2006, 10(6):855-862.
|
15. |
Chen XP, Qiu FZ, Wu ZD, et al. Effects of location and extension of portal vein tumor thrombus on long-term outcomes of surgical treatment for hepatocellular carcinoma [J]. Ann Surg Oncol, 2006, 13(7):940-946.
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16. |
Yeh CN, Chen MF, Lee WC, et al. Prognostic factors of hepatic resection for hepatocellular carcinoma with cirrhosis:univariate and multivariate analysis [J]. J Surg Oncol, 2002, 81(4):195-202.
|
17. |
Neeff H, Makowiec F, Harder J, et al. Hepatic resection for hepatocellular carcinoma—— results and analysis of the current literature [J]. Zentralbl Chir, 2009, 134(2):127-135.
|
18. |
王春, 陈哲宇, 曾勇, 等. Ⅳ型肝门部胆管癌的治疗体会 [J].中国普外基础与临床杂志, 2012, 19(1):62-65.
|
19. |
樊嘉, 周俭, 吴志全, 等. 不同化疗模式及不同给药途径对肝癌合并门静脉癌栓术后化疗作用的比较研究 [J]. 中华肝胆外科杂志, 2003,9(6):334-337.
|
20. |
Fan J, Wu ZQ, Tang ZY, et al. Muhimodality treatment inhepatocellular carcinoma patients with tumor thrombi in portal vein [J]. World J Gastroenterol, 2001, 7(1):28-32.
|
21. |
程树群, 钱德初, 吴孟超, 等. 超声消融术对癌细胞超微结构和细胞周期的影响 [J]. 中国微创外科杂志, 2005, 5(2):119-121.
|
22. |
曾昭冲, 汤钊猷, 杨秉辉. 肝细胞癌转移复发的放射治疗 [J].实用肿瘤杂志, 2003, 18(4):251-256.
|
23. |
Yamada K, Izaki K, Sugimoto K, et al. Prospective trial of combined transcatheter arterial chemoembolization and three-dimensional conformal radiotherapy for portal veintumor thrombus in patients with unresectable hepatocellular carcinoma [J]. Int J Radiat Oncol Biol Phys, 2003, 57(1):113-119.
|
24. |
张宁宁, 饶荣生. 肝癌伴门静脉癌栓的治疗进展 [J]. 肝胆胰外科杂志, 2008, 20(1):66-69.
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- 1. 樊嘉, 黄成. 肝癌门静脉癌栓的外科治疗 [J]. 中国普外基础与临床杂志, 2004, 11(5):380-382.
- 2. 樊嘉, 吴志全, 周俭. 肝细胞癌伴门静脉癌栓不同治疗方法的比较 [J]. 中华肿瘤杂志, 2000, 22(3):247-249.
- 3. 程树群, 吴孟超. 肝癌门静脉癌栓临床研究进展和展望 [J].中国微创外科杂志, 2007,7(1):6-7.
- 4. 王晓颖, 樊嘉. 肝癌合并门静脉癌栓的治疗方法及价值 [J].肝胆外科杂志, 2009, 17(1):9-11.
- 5. 严律南, 陈晓理, 李志辉, 等. 肝癌肝切除术围手术期处理的临床研究( 附2 143 例报告) [J]. 中国普外基础与临床杂志,2005,12(2):162-166.
- 6. 文天夫, 严律南. 肝切除术中肝脏血流阻断技术的研究进展 [J]. 中国普外基础与临床杂志, 2008, 15(4):299-302.
- 7. 柴天桥, 靳曙光, 陈哲宇. 复杂巨大肝肿瘤的精确切除体会 [J]. 中国普外基础与临床杂志, 2011,18(9):952-955.
- 8. 吴孟超. 原发性肝癌伴门静脉癌栓的外科治疗 [J]. 中华医学杂志, 2004, 84(1):1-2.
- 9. 胡文杰, 梁力建, 周奇, 等. 化疗联合免疫治疗在提高肝癌合并门静脉癌栓术后疗效中的作用 [J]. 中华外科杂志, 2007,45(19):1325-1327.
- 10. Timothy MP, Ronnie TP, Abdalla EK, et al. Hepatectomy for hepatocellular carcinoma with major portal or hepatic vein invasion:results of a multicenter study [J]. Surgery, 2005,137(4):403-410.
- 11. 刘宇斌, 简志祥, 区金锐, 等. 原发性肝癌合并门静脉癌栓的外科治疗方式选择 [J]. 中华外科杂志, 2005, 43(7):436-438.
- 12. 程树群, 吴孟超, 陈汉, 等. 癌栓分型对肝细胞性肝癌合并门静脉癌栓治疗和预后的指导意义 [J]. 中华医学杂志, 2004,84(1):3-5.
- 13. Ando E, Tanaka M, Yamashita F, et al. Hepatic arterial infusion chemotherapy for advanced hepatocellular carcinoma with portal vein tumor thrombosis: analysis of 48 cases [J]. Cancer, 2002,95(3):588-595.
- 14. Le Treut YP, Hardwigsen J, Ananian P, et al. Resection of hepatocellular carcinoma with tumor thrombus in the major vasculature. A European case-control series [J]. J Gastrointest Surg, 2006, 10(6):855-862.
- 15. Chen XP, Qiu FZ, Wu ZD, et al. Effects of location and extension of portal vein tumor thrombus on long-term outcomes of surgical treatment for hepatocellular carcinoma [J]. Ann Surg Oncol, 2006, 13(7):940-946.
- 16. Yeh CN, Chen MF, Lee WC, et al. Prognostic factors of hepatic resection for hepatocellular carcinoma with cirrhosis:univariate and multivariate analysis [J]. J Surg Oncol, 2002, 81(4):195-202.
- 17. Neeff H, Makowiec F, Harder J, et al. Hepatic resection for hepatocellular carcinoma—— results and analysis of the current literature [J]. Zentralbl Chir, 2009, 134(2):127-135.
- 18. 王春, 陈哲宇, 曾勇, 等. Ⅳ型肝门部胆管癌的治疗体会 [J].中国普外基础与临床杂志, 2012, 19(1):62-65.
- 19. 樊嘉, 周俭, 吴志全, 等. 不同化疗模式及不同给药途径对肝癌合并门静脉癌栓术后化疗作用的比较研究 [J]. 中华肝胆外科杂志, 2003,9(6):334-337.
- 20. Fan J, Wu ZQ, Tang ZY, et al. Muhimodality treatment inhepatocellular carcinoma patients with tumor thrombi in portal vein [J]. World J Gastroenterol, 2001, 7(1):28-32.
- 21. 程树群, 钱德初, 吴孟超, 等. 超声消融术对癌细胞超微结构和细胞周期的影响 [J]. 中国微创外科杂志, 2005, 5(2):119-121.
- 22. 曾昭冲, 汤钊猷, 杨秉辉. 肝细胞癌转移复发的放射治疗 [J].实用肿瘤杂志, 2003, 18(4):251-256.
- 23. Yamada K, Izaki K, Sugimoto K, et al. Prospective trial of combined transcatheter arterial chemoembolization and three-dimensional conformal radiotherapy for portal veintumor thrombus in patients with unresectable hepatocellular carcinoma [J]. Int J Radiat Oncol Biol Phys, 2003, 57(1):113-119.
- 24. 张宁宁, 饶荣生. 肝癌伴门静脉癌栓的治疗进展 [J]. 肝胆胰外科杂志, 2008, 20(1):66-69.