超出米兰标准的肝癌患者综合治疗和肝移植的疗效比较

刘建勇; 蔡秋程; 江艺

doi:10.3969/j.issn.1001-5256.2014.09.019

超出米兰标准的肝癌患者综合治疗和肝移植的疗效比较

DOI: 10.3969/j.issn.1001-5256.2014.09.019

南京军区福州总医院肝胆外科

基金项目:

福建省自然基金重点项目(2011Y0046)；军区医学科技创新重点课题(11Z033)；

详细信息

中图分类号: R735.7
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出版历程
- 收稿日期: 2014-01-21
- 出版日期: 2014-09-20

Clinical effects of comprehensive treatment and liver transplantation for hepatocellular carcinoma exceeding Milan criteria: a comparative study

Department of Hepatobiliary Surgery, Fuzhou General Hospital of Nanjing Military Region

Research funding:

摘要

摘要:
目的分析比较超出米兰标准但符合上海标准与超出上海标准的原发性肝癌患者综合治疗与肝移植的临床疗效。方法回顾性分析2006年1月至2010年1月南京军区福州总医院收治的,超出米兰标准的不能接受手术切除的157例原发性肝癌患者的临床资料。其中综合治疗99例,符合上海标准者48例;肝移植58例,符合上海标准者26例。计量资料组间比较采用t检验,计数资料采用卡方检验或Fisher精确概率法。用Kaplan-Meier法计算两组治疗方法中位生存期,1、2及3年累积存活率,并用Log-Rank检验比较各组生存曲线的差异。结果综合治疗组与肝移植组中位生存期分别为（18.00±1.15）个月及（23.40±4.44）个月,3年累积存活率分别为（18.2±3.9）%和（39.7±6.4）%。两组生存曲线Log-Rank检验差异有统计学意义（P=0.009）。两组超出米兰标准但符合上海标准者,中位生存时间分别为（20.00±1.17）和（36.00±0.00）个月,3年累积存活率分别为（25.0±6.3）%和（57.7±9.7）%。两组生存曲线比较,差异有统计学意义（P=0.008）。超出上海标准者,两组中...
- 肝肿瘤 /
- 综合疗法 /
- 肝移植
Abstract:
Objective To analyze and compare the clinical effects of comprehensive treatment and liver transplantation for hepatocellular carcinomas ( HCC) exceeding Milan criteria. Methods A retrospective analysis was performed on the clinical data of 157 patients with HCC ( exceeding Milan criteria) who received comprehensive treatment ( 99 patients, including 48 cases meeting Shanghai criteria) and liver transplantation ( 58 patients, including 26 cases meeting Shanghai criteria) in our hospital from January 2006 to January 2010. The median survival times and 1-, 2-, and 3- year survival rates were calculated by the Kaplan- Meier method, and the log- rank test was used for survival difference analysis. Results For all patients, the median survival times of the comprehensive treatment group and liver transplantation group were 18. 00 ± 1. 15 and 23. 40 ± 4. 44 months, respectively, and their 3- year survival rates were ( 18. 2 ± 3. 9) % and ( 39. 7 ±6.4) %, respectively; the survival was significantly improved by the treatment of liver transplantation ( P =0.009) . For patients meeting Shanghai criteria, the median survival times of the comprehensive treatment group and liver transplantation group were 20. 00 ± 1. 17 and 36. 00 ± 0. 00 months, respectively, and their 3- year survival rates were ( 25. 0 ± 6. 3) % and ( 57. 7 ± 9. 7) %, respectively; there was significant survival difference between the two groups ( P = 0. 008) . For patients exceeding Shanghai criteria, the median survival times of the comprehensive treatment group and liver transplantation group were 16. 00 ± 1. 78 and 16. 00 ± 1. 69 months, respectively, and their 3- year survival rates were ( 11. 8 ± 4. 5) % and ( 25. 0 ± 7. 7) %, respectively; there was no significant survival difference between the two groups ( P = 0. 221) . Conclusion Compared with comprehensive treatment, liver transplantation leads to a significant higher long- term survival rate in HCC patients exceeding Milan criteria but meeting Shanghai criteria. However, the two therapies cause no significant survival difference in HCC patients exceeding Shanghai criteria.
- liver neoplasms /
- combined modality therapy /
- liver transplantation

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参考文献(13)

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