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目的通过对肝细胞肝癌(HCC)切除术后复发并再次手术病例临床资料的回顾性分析,探讨HCC术后复发时间对再次手术预后的影响。方法 2005年1月至2010年1月,我中心收治HCC术后复发并再次施行肝切除手术共25例,全部病例再次手术前均通过影像学检查明确为肝内复发并除外肝外转移,术后通过数字减影血管成像技术(DSA)进行随诊;再次手术术后随访时间均超过12个月。结果根据首次手术术后复发时间分为两组,术后12个月内复发17例,再次手术后12个月内再次复发16例,复发率94.1%;术后复发时间超过12个月病例8例,再次手术后12个月内再次复发2例,复发率25.0%,两组首次手术后无病生存时间、复发后生存时间和总生存时间均有统计学差异(χ2=11.091,P=0.001;χ2=4.864,P=0.027;χ2=9.694,P=0.002);再次手术时12个月内复发组平均年龄明显小于12个月以上复发组[(48.5±10.0)岁vs.(55.6±8.2)岁,t=-2.416,P=0.019]。结论 HCC术后早期复发提示再次手术预后不佳,复发率高,12个月内复发病例特别是年轻病例不宜过早进行再次手术;复发时间超过12个月的HCC病例再次手术后1年复发率较低、预后好,应采取积极治疗。
Objective To retrospectively analyze the clinical data of patients with recurrent and recurrent hepatocellular carcinoma (HCC) after resection to investigate the effect of recurrence time after HCC on the prognosis of reoperation. Methods From January 2005 to January 2010, 25 cases of recurrent and recurrent HCC underwent liver resection in our center. All cases were confirmed by imaging examination for intrahepatic recurrence and extrahepatic metastasis before surgery Followed by digital subtraction angiography (DSA) were followed up; reoperation were followed up for more than 12 months. The results were divided into two groups according to the time of the first postoperative recurrence, 17 cases relapsed within 12 months after operation, and 16 cases relapsed within 12 months after reoperation, the recurrence rate was 94.1%. The recurrence time was longer than 12 months. Case 8 For example, 2 cases relapsed within 12 months after reoperation, the recurrence rate was 25.0%. The disease-free survival time, the survival time and the total survival time after recurrence were significantly different between the two groups (χ2 = 11.091, P = 0.001 ; χ2 = 4.864, P = 0.027; χ2 = 9.694, P = 0.002). The average age of relapse group within 12 months after reoperation was significantly shorter than that of recurrence group over 12 months [(48.5 ± 10.0) vs. (55.6 ± 8.2 ) Years old, t = -2.416, P = 0.019]. Conclusions The early recurrence of HCC suggests that the reoperation has a poor prognosis and a high recurrence rate. It is not advisable to carry out reoperation prematurely within 12 months, especially in young cases. The recurrence rate of HCC after recurrence for more than 12 months Lower, good prognosis, should take active treatment.