期刊文献+

肝切除术治疗大/多结节或大血管侵犯肝细胞癌效果的荟萃分析 被引量:3

Hepatic resection for hepatocellular carcinoma involving a single large tumor, multiple tumors or macrovascular invasion
分享 导出
摘要 目的 系统分析巴塞罗那临床肝癌分期系统(BCLC)不推荐肝切除术治疗大肿瘤(>5 cm)/多结节(>2个)或大血管侵犯的肝细胞癌(HCC)肝切除术治疗患者的疗效及安全性.方法 系统检索PubMed数据库,分析肝切除术治疗大/多结节或大血管侵犯的HCC的疗效及安全性的研究.结果 52个研究评价了肝切除术治疗大/多结节HCC的疗效和安全性,包含14 922例患者.评价肝切除治疗大血管侵犯HCC的研究25个,共4 412例患者.总样本分析显示,亚洲患者围手术期中位死亡率显著低于非亚洲患者(2.7%与7.3%,P <0.001).对于大/多结节HCC,亚洲患者的1、5年中位总生存率均显著高于非亚洲患者(81%与65%,P<0.001;42%与32%,P<0.001).然而,对于大血管侵犯的HCC,亚洲患者的1、5年中位总生存率与非亚洲患者相似(50%与52%,P=0.46;18%与15%,P=0.95).随着时间的推移,近30年患者5年总生存率呈显著上升趋势(P<0.001).结论 肝切除术治疗大/多结节或大血管侵犯的HCC是安全有效的.目前证据显示,有必要扩大欧美HCC治疗指南中肝切除术的适应证. Objective To investigate the safety and efficacy of hepatic resection for those patients with large/multinodular hepatocellular carcinoma (HCC) or those involving macrovascular invasion (MVI).Methods PubMed was systematically searched for studies examining the safety and efficacy of hepatic resection for treatment of HCC involving a single large tumor (〉 5 cm) or multiple tumors (〉 2),or those involving MVI.Results The identified 52 studies involving 14 922 patients that investigated the use of hepatic resection for large/multinodular HCC,and 25 studies with 4 412 patients that investigated hepatic resection for HCC with MVI.Median in-hospital mortality of patients with either type of HCC was significantly lower in Asian studies (2.7%) than in non-Asian studies (7.3%,P 〈 0.001).Median overall survival rate was significantly higher for all Asian patients with large/multinodular HCC than for all non-Asian patients both at the time of 1 year (81% vs 65%,P 〈0.001) and 5 years (42% vs 32%,P 〈 0.001).However,median overall survival rate was similar for Asian and non-Asian patients with HCC involving MVI at the time of 1 year (50% vs 52%,P=0.46) and 5 years (18% vs 15%,P=0.95).There was an increasing trend in 5-year overall survival in patients with either type of HCC.Conclusions Hepatic resection is reasonably safe and effective for the treatment of large/multinodular HCC and HCC with MVI.The available evidence argues for expanding the indications for hepatic resection in official treatment guidelines.
作者 李威 游雪梅 黎乐群 钟鉴宏 Li Wei, You Xuemei, Li Lequn, Zhong Jianhong (Department of Hepatobiliary Surgery, Affiliated Tumor Hospital of Guangxi Medical University, Nanning 570021 China)
出处 《中华医学杂志》 CAS CSCD 北大核心 2015年第38期3115-3118,共4页 National Medical Journal of China
基金 国家科技重大专项(2012ZX102010001009) 广西医科大学青年科学基金(GXMUYSF201302) 广西高校科学技术研究项目(KY2015LX056)
关键词 肝细胞癌 肝切除术 多结节 大血管侵犯 总生存率 Hepatocellular Neoplasms Hepatic resection Multinodular Macrovascular Invasion Overall Survival
作者简介 通信作者:钟鉴宏,Email:zhong,jianhong66@163.com
  • 相关文献

参考文献14

  • 1Zhong JH, Ke Y, Wang YY,et al. Liver resection for patientswith hepatocellular carcinoma and macrovascular invasion,multiple tumours, or portal hypertension[ J]. Gut,2015 , 64(3):520-521. 被引量:1
  • 2Fomer A, Gilabert M, Bruix J, et al. Treatment of intermediate-stage hepatocellular carcinoma[ J]. Nat Rev Clin Oncol,2014,11(9);525-535. 被引量:1
  • 3Zhong JH, Ke Y, Gong WF, et al. Hepatic resection associatedwith good survival for selected patients with intermediate andadvanced-stage hepatocellular carcinoma [ J ]. Ann Surg, 2014,260(2) :329-340. 被引量:1
  • 4Torzilli G,Belghiti J, Kokudo N, et al. A snapshot of theeffective indications and results of surgery for hepatocellularcarcinoma in tertiary referral centers . is it adherent to the EASL/AASLD recommendations. : an observational study of the HCCEast-West study group[J]. Ann Surg,2013 ,257(5 ) ; 929-937. 被引量:1
  • 5Arii S,Sata M,Sakamoto M,et al. Management of hepatocellularcarcinoma : Report of Consensus Meeting in the 45 th AnnualMeeting of the Japan Society of Hepatology (2009) [ J]. HepatolRes, 2010,40(7) :667-685. 被引量:1
  • 6Hsu CY, Hsia CY, Huang YH, et al. Comparison of surgicalresection and transarterial chemoembolization for hepatocellularcarcinoma beyond the Milan criteria: a propensity score analysis[J]. Ann Surg Oncol,2012,19(3) :842-849. 被引量:1
  • 7Wang JH, Kuo YH, Wang CC, et al. Surgical resection improvesthe survival of selected hepatocellular carcinoma patients inBarcelona clinic liver cancer stage C[ J]. Dig Liver Dis,2013 ,45(6):510-515. 被引量:1
  • 8Jamagin WR,Gonen M,Fong Y,et al. Improvement inperioperative outcome after hepatic resection: analysis of 1,803consecutive cases over the past decade [ J ]. Ann Surg, 2002 ,236.4) :397406. 被引量:1
  • 9Lim KC, Chow PK, Allen JC, et al. Systematic review ofoutcomes of liver resection for early hepatocellular carcinomawithin the Milan criteria [ J]. Br J Surg, 2012 ,99 ( 12 ) : 1622-1629. 被引量:1
  • 10Tsoulfas G, Mekras A, Agorastou P, et al. Surgical treatment forlarge hepatocellular carcinoma : does size matter. [ J ]. ANZ JSurg, 2012,82(7-8) :510-517. 被引量:1

二级参考文献41

  • 1Lencioni R,Chen XP,Dagher L,et al.Treatment of intermediate/ad-improved[J ].Oncologist, 2010,15 Suppl 4:42-52. 被引量:1
  • 2Bruix J,Sherman M.Management of hepatocellular carcinoma:an up-date[j].Hepatology,2011,53(3) :1020-1022. 被引量:1
  • 3Cillo U,Vitale A,Grigoletto F,et al.Prospective validation of theBarcelona Clinic Liver Cancer staging system[j].j Hepatol, 2006,44(4):723-731. 被引量:1
  • 4Cabibbo G,Enea M,Attanasio M,et al.A meta-analysis of survivalrates of untreated patients in randomized clinical trials of hepatocel-lular carcinoma[J].Hepatology,2010,51(4) : 1274-1283. 被引量:1
  • 5Bruix J,Sherman M,Llovet JM,et al.Clinical management of hepa-tocellular carcinoma.Conclusions of the Barcelona-2000 EASL con-ference.European Association for the Study of the Liver [ j] J Hepa-tol,2001,35(3) :421-430. 被引量:1
  • 6Bruix J,Llovet JM.Prognostic prediction and treatment strategy inhepatocellular carcinoma[J].Hepatology,2002,35(3):519-524. 被引量:1
  • 7Befeler AS,Di Bisceglie AM.Hepatocellular carcinoma:diagnosis andtreatment [ J ] .Gastroenterology, 2002,122( 6 ) : 1609-1619. 被引量:1
  • 8Hassoun Z,Gores GJ.Treatment of hepatocellular carcinoma[J].ClinGastroenterol Hepatol,2003,1(1):10-18. 被引量:1
  • 9Zhong JH,Xiang BD,Gong WF,et al.Comparison of long-term sur- vival of patients with BCLC stage B hepatocellular carcinoma after liver resection or transarterial ehemoembolization [ J ].PLoS One, 2013,8 (7) :e68193. 被引量:1
  • 10Zhang CY,Huang TR,Yu JH,et al.Epidemiological analysis of pri-mary liver cancer in the early 21st century in Guangxi province ofChina[j].Chin J Cancer,2010,29(5) :545-550. 被引量:1

共引文献8

同被引文献23

  • 1Bruix J,Sherman M,American Association for the Study of LiverDiseases. Management of hepatocellular carcinoma : an update[J]. Hepatol,2011,53(3) : 1020-1022. 被引量:1
  • 2European Association for the study of the liver; Europeanorganisation for research and treatment of cancer. EASL-EORTCclinical practice guidelines : management of hepatocellularcarcinoma [ J]. J Hepatol,2012,56(4) :908-943. 被引量:1
  • 3Zhong JH, Li H,Xiao N, et al. Hepatic resection is safe andeffective for patients with hepatocellular carcinoma and portalhypertension[ J] . PLoS One,2014,9(9) :el08755. 被引量:1
  • 4Ruzzenente A, Valdegamberi A, Campagnaro T, et al.Hepatocellular carcinoma in cirrhotic patients with portalhypertension; is liver resection always contraindicated[ J] . WorldJ Gastroenterol,2011,17(46) :5083-5088. 被引量:1
  • 5Guglielmi A,Ruzzenente A, Conci S,et al. Hepatocellularcarcinoma : surgical perspectives beyond the barcelona clinic livercancer recommendations[ J]. World J Gastroenterol: WJG,2014,20(24) :7525-7533. 被引量:1
  • 6Lin CT,Hsu KF, Chen TW, et al. Comparing hepatic resectionand transarterial chemoembolization for Barcelona Clinic LiverCancer ( BCLC ) stage B hepatocellular carcinoma : change fortreatment of choice[ J] . World J Surg,2010,34(9) :2155-2161. 被引量:1
  • 7Farinati F, Vanin V,Giacomin A, et al. BCLC stage Bhepatocellular carcinoma and transcatheter arterialchemoembolization : a 20-year survey by the Italian Liver Cancergroup. Liver international : official journal of the InternationalAssociation for the Study of the Liver [ J ]. Liver Int, 2015 , 35(1):223-231. 被引量:1
  • 8Yin L, Li H, Li AJ, et al. Partial hepatectomy vs. transcatheterarterial chemoembolization for resectable multiple hepatocellularcarcinoma beyond Milan Criteria: a RCT[ J] . J Hepatol,2014,61.1):82-88. 被引量:1
  • 9Torzilli G, Belghiti J, Kokudo N, et al. A snapshot of theeffective indications and results of surgery for hepatocellularcarcinoma in tertiary referral centers : is it adherent to the EASL/AASLD recommendations.: an observational study of the HCCEast-West study group[ J]. Ann Surg,2013 ,257(5) :929-937. 被引量:1
  • 10Zhang ZM,Lai EC,Zhang C,et al. The strategies for treatingprimary hepatocellular carcinoma with portal vein tumor thrombus[J]. Int JSui^,2015,20;8-16. 被引量:1

引证文献3

二级引证文献4

投稿分析

相关作者

内容加载中请稍等...

相关机构

内容加载中请稍等...

相关主题

内容加载中请稍等...

浏览历史

内容加载中请稍等...
;
使用帮助 返回顶部 意见反馈