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目的 报道肝癌切除术后肝内复发的综合治疗效果。方法 我院1987～1998年12月期间的肝癌切除术后复发病例284例,采用再次手术切除56例;肝动脉栓塞化疗158例;瘤内无水酒精注射15例。结果 再切除病例的1、3、5年生存率为61.7％、37.1％、25.5％;TACE治疗的1、2、3年生存率为49.3％、28.7％、19.6％。结论 再次手术切除是治疗术后复发的最有效方法,术后辅助性经皮肝动脉栓塞化疗是发现和治疗术后早期复发的理想方法,效果优于发现复发后再作TACE,对术后高危复发病例应作术后辅助性TACE。
Objective To report the comprehensive treatment effect of intrahepatic recurrence after hepatectomy. Methods 284 cases of recurrence of hepatocellular carcinoma during our hospital from December 1987 to December 1998, 56 cases were treated with reoperation, 158 cases were treated with hepatic artery embolization, and 15 cases were intratumoral ethanol injection. Results The 1-, 3-, and 5-year survival rates of resected cases were 61.7%, 37.1%, and 25.5%. The 1-, 2-, and 3-year survival rates of TACE treatment were 49.3%, 28.7%, and 19.6%. Conclusions The second surgical resection is the most effective method to treat postoperative recurrence. Postoperative adjuvant percutaneous transcatheter arterial chemoembolization is an ideal method for detecting and treating early postoperative recurrence. It is superior to TACE after recurrence and high risk after operation. Recurrent cases should be postoperative adjuvant TACE.