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目的 探讨非规则性肝切除及癌栓摘除术联合肝动脉化学药物治疗 (化疗 ) (hepaticarterychemotherapy ,HAC)及门静脉化疗 (portalveinchemotherapy ,PVC)治疗肝细胞癌 (hepatocellularcar cinoma ,HCC)合并门静脉癌栓 (portalveintumorthrombi,PVTT)的价值。方法 总结 1987年 1月～1996年 12月采用非规则性肝切除及癌栓摘除术治疗HCC合并PVTT的患者 6 2例 ,其中 ,40例在术后联合HAC和PVC。 5 9例获随访 3年。结果 6例在术后 3个月内死于肝、肾功能衰竭 ,5 6例术后恢复良好。术后 1、2、3年的复发率和生存率 ,在手术后应用HAC和PVC组分别为 46 % (18/ 39)、5 9%(2 3/ 39)、79% (31/ 39)和 6 9% (2 7/ 39)、5 1% (2 0 / 39)、31% (12 / 39) ,而在未化疗组分别为 80 % (16 / 2 0 )、90 % (18/ 2 0 )、10 0 % (2 0 / 2 0 )和 30 % (6 / 2 0 )、10 % (2 / 2 0 )、5 % (1/ 2 0 )。结论 非规则性肝切除和癌栓摘除术是HCC合并PVTT有效的治疗方法 ,术后联合HAC和PVC可降低复发率、提高生存率。
Objective To investigate the treatment of irregular hepatectomy and tumor thrombectomy combined with hepatic artery chemotherapy (HAC) and portal vein chemotherapy (PVC) for hepatocellular carcinoma (HCC) combined with portal vein tumor thrombi (portal vein tumor thrombi) The value of PVTT). METHODS: From January 1987 to December 1996, 62 patients with HCC and PVTT were treated with irregular liver resection and thrombectomy. Among them, 40 patients were treated with combined HAC and PVC. Fifty-nine cases were followed up for 3 years. Results Six cases died of liver and kidney failure within 3 months after operation, and 56 cases recovered well after operation. The recurrence rate and survival rate at 1, 2 and 3 years after operation were 46% (18/39), 59% (23/39), and 79% (31/39) in the HAC and PVC groups after surgery. And 6 9% (27/39), 5 1% (20/39), 31% (12/39), and 80% (16/20), 90% (18/18) in the non-chemotherapy group. 2 0), 10 0 % (2 0 / 2 0) and 30% (6 / 2 0), 10 % (2 / 2 0), and 5% (1/ 2 0). Conclusion Irregular liver resection and tumor thrombectomy are effective treatments for HCC with PVTT. Postoperative combined HAC and PVC can reduce the recurrence rate and improve the survival rate.