摘要
目的分析肝细胞癌肝切除术中,经大网膜静脉注射丝裂霉素(Mitomycin-C,MMC)预防术后肿瘤复发的疗效。方法回顾分析2002年1月至2003年12月298例肝细胞癌行肝切除患者的临床资料。其中术中经大网膜静脉注射MMC的用药组共计139人,未行任何化疗药物注射的对照组共计159人,随访术后复发情况。结果用药组与对照组总体无瘤生存期无显著差别,中位无瘤生存期分别为:术后9.5月、6月(P=0.112)。作分层分析提示:肿瘤单发、最大直径小于5cm、镜下无门脉癌栓者,用药组无瘤生存期显著长于对照组,中位无瘤生存期分别为:13月、8月(P=0.0068);18月、11月(P=0.0404);28月、10月(P=0.0152)。其余条件,用药组与对照组无瘤生存期均无显著差别。结论肝细胞癌行肝切除术,术中经大网膜静脉注射丝裂霉素,对于预防术后复发有一定的积极意义,但应根据肿瘤的大小、门静脉癌栓及肿瘤的数量等情况调整用药剂量,以取得更好的疗效。同时前瞻性研究有还将着眼于联合其他化疗药物以提高术中化疗在预防术后肝细胞癌复发的价值。
Objective To estimate the value of the methed of MMC injected via omentum majus veins after the resction of tumor during the operation to prevent the recurrence of HCC. Methods A retrospective analysis of 298 patients was done. All of them received liver resection of HCC from 2002 Jan. to 2003 Dee. Group A include 139 patients who was injected MMC via omentum majus veins after the liver tumor was resected. 159 patients who was not injected MMC was recruited to group B. Results There was no significant difference between two group of the period of disease-free survival（DFS） ,and median period of DFS of goup A vs. group B was 9.5 month vs 6 month after the first operation（ P = 0. 112）. Stratification analysis showed that the median period of DFS was significant difference between two group with single tumor, tumor diameter 〈 5 cm or tumor without PVTT of micro. The median period of DFS was respectively 13 month vs 8 month （ P = 0. 0068 ） , 18 month vs 11 month （ P = 0. 0404 ） and 28 month vs I 0 month （ P = 0.0152 ）. No significant difference was found between two group with other factors. Conclusion Injection of MMC via omentum majus veins after the liver tumor was resected is a valuable methed to prevent the recurrence of HCC. More dosage of MMC or combination with other drugs would get better result. We need a prospective study to prove it.
出处
《肝胆外科杂志》
2008年第6期420-423,共4页
Journal of Hepatobiliary Surgery
关键词
肝细胞癌
肝切除
复发
化疗
大网膜静脉
丝裂霉素
hepatoeellnlar carcinoma
hepateetomy
recurrence
chemotherapy
omentum majus veins
mitomycin-C
